Providers

The Patient-Centered Outcomes Research Institute (PCORI) fee was set to expire in 2019 for most self-insured health plans (2020 for others), but the SECURE Act has extended it for 10 years.

In Revenue Procedure 2019-29, the IRS announced that the 2020 shared-responsibility affordability percentage will be decreased from the 2019 limit. Under the Affordable Care Act (ACA), employer-sponsored health coverage will satisfy the affordability requirement if the lowest-cost self-only coverage option available to employees does not exceed 9.78 percent of an employee’s household income.

As of January 1, 2020, responsible reporting entities (RREs) must report prescription-drug coverage to the Centers for Medicare & Medicaid Services (CMS). Currently, RREs are required to report information to CMS about individuals who are entitled to Medicare and are covered under a group health plan, so CMS may determine whether the plan is primary to (pays before) Medicare.

The Patient-Centered Outcomes Research Institute (PCORI) fee under the Affordable Care Act is due from sponsors of applicable self-funded health plans by July 31, 2019.

The IRS has released the 2020 cost-of-living amounts (COLAs) for HSA-qualifying high-deductible health plans.