PCORI Fee Increase Announced

The applicable dollar amount to determine the fees which help fund the Patient-Centered Outcomes Research Institute (PCORI) will increase from $2.79 to $3.00 for plan years ending after September 30, 2022 and before October 1, 2023 according to IRS Notice 2022-59 issued by the Internal Revenue Service (IRS) on November 14, 2022.

For more information on the PCORI fee download the TMC Newsletter here: https://www.mckeogh.com/wp-content/uploads/Health-News-01.10.2023-PCORI-Fee-Increase.pdf

2023 Medicare Parts A and B Cost Sharing Amounts

The Centers for Medicare and Medicaid Services (CMS) released the 2023 premiums, deductibles and coinsurance amounts for Medicare Part A and Part B.  While cost sharing for Medicare Part A services will increase in 2023, cost sharing for Medicare Part B services will decrease. 

Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation and some home health care services.  The inpatient hospital deductible covers the first 60 days of Medicare-covered inpatient hospital care and will increase from $1,556 in 2022 to $1,600 in 2023.  For the 61st through 90th day of a hospitalization, the coinsurance amount will increase from $389 per day in 2022 to $400 per day in 2023.  After the 90th day, lifetime reserve days may be used after paying a coinsurance amount of $800 per day, which is an increase from the 2022 amount of $778 per day.  The daily coinsurance for days 21 through 100 of extended care services in a skilled nursing facility will increase from $194.50 per day in 2022 to $200 per day in 2023.

Medicare Part B covers physician services, outpatient hospital services, some home health services, durable medical equipment and other medical services not covered by Medicare Part A.  The standard monthly premium for Medicare Part B coverage will decrease from the 2022 amount of $170.10 to $164.90 in 2023.  The annual deductible for Part B beneficiaries will decrease from $233 in 2022 to $226 in 2023.

Plans that reimburse Medicare-eligible retirees through a Medicare Supplemental benefit will need to make the necessary decisions and adjustments to the plan of benefits to incorporate these changes to Part A and Part B cost sharing amounts.

CMS Website: https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly

2021 Consolidated Appropriations Act Requirements

The Consolidated Appropriations Act became law on December 27, 2020 and introduces a host of new compliance requirements for Health and Welfare Funds. The attached newsletter discusses these requirements including:

  • Mental Health Parity and Addiction Equity Act (MHPAEA) Comparative Analysis
  • Prohibition of Gag Clauses
  • Broker and Consultant Compensation Disclosure
  • Medical and Drug Cost Reporting

Download the TMC Newsletter here: https://www.mckeogh.com/wp-content/uploads/Health-News-July-6-2021-CAA-Requirements.pdf

COBRA Subsidies Available for COVID Relief

The American Rescue Plan Act of 2021 (ARPA) was passed into law on March 11, 2021 by President Biden. This law provides 100% tax-free subsidies for COBRA continuation coverage to eligible individuals for six months. The subsidy will begin on April 1, 2021 and end on September 30, 2021.

For more information on eligibility, notice requirements, tax credits and actionable steps, download the TMC Newsletter here: https://www.mckeogh.com/wp-content/uploads/TMC-Health-News-March-15-2021-COBRA-Subsidies.pdf