The Affordable Care Act (ACA) established a private, non-profit corporation called the Patient-Centered Outcomes Research Institute to conduct comparative clinical effectiveness research. Under the ACA, health insurance carriers and plan sponsors of self-funded medical plans, Health Reimbursement Arrangements (HRA) and Medical Expense Reimbursement Plans (MERP) are required to pay fees to help finance the Institute's research. These fees are widely known as PCORI fees.

The PCORI fees were scheduled to expire for plan or policy years ending on or after Oct. 1, 2019. However, a federal spending bill enacted at the end of 2019 extended the PCORI fees for an additional 10 years . As a result, on June 8, 2020, the IRS published Notice 2020-44, which provides the adjusted PCORI fee amount for plan years ending on or after October 1, 2019 through September 30, 2020.