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IRS slightly boosts medical outcomes research fee

Posted On: Oct. 9, 2015 12:00 AM CST

A medical outcomes research fee mandated by the health care reform law and paid by self-funded employers and insurers is going up slightly, the Internal Revenue Service said.

The fee, known as the Patient-Centered Outcomes Research Fee, will be bumped up to $2.17 per plan participant for plan years ending on or after Oct. 1, 2015, and before Oct. 1, 2016, the IRS said Friday.

While the fee does not have to be paid until July 31, 2016, the higher fee would apply retroactively to calendar-year plans, which are the vast majority of group health care plans, since their plan years would end after Oct. 1, 2015.

The fee initially was set at $1 per plan participant for the first plan year ending after Sept. 30, 2012, and at $2 per participant in succeeding years.

For plan years starting after Sept. 30, 2014, the fee is indexed to reflect the percentage increase in national medical expenditures as determined by the U.S. Department of Health and Human Services.

The fee applies to all health care plan participants, including those in retiree-only plans, even though such plans are largely exempt from the Patient Protection and Affordable Care Act.

In the case of self-funded plans, the fee is paid by employers, while insurers are liable for the fee in plans they insure.