A provision in the Consolidated Appropriations Act (CCA) of 2021 requires prescription drug reporting. Under the provision insurance companies and employer-based health plans must submit information about prescription drugs and health care spending. This data submission is called the RxDC report. This is an annual reporting requirement, and 2022 data is due to CMS by June 1, 2023.
The CAA requires insurance companies and employer-based health plans to submit information about:
- Spending on prescription drugs and health care services;
- Prescription drugs that account for the most spending;
- Drugs that are prescribed most frequently;
- Prescription drug rebates from drug manufacturers; and
- Premiums and cost-sharing that patients pay.
Employers may use issuers, third-party administrators (TPAs), pharmacy benefit managers (PBMs) or other third parties to submit the RxDC reports on their behalf.
Next Steps for Employers
For fully insured employers, the carrier will be responsible for completing the necessary reporting, but employers should work with their carrier to supply any requisite data, if needed. Employers who sponsor self-funded health plans should coordinate with their self-funded TPA and pharmacy benefit manager to ensure timely data reporting.
