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Prescription Drug Data Collection (RxDC) Resources

The RxDC reporting provision of the Consolidated Appropriations Act (CAA) requires reports on drug utilization and spending trends to be submitted to U.S. Department of Health and Human Services. Reports are due annually by June 1. 

View the Amwins Connect Health Cost Transparency Guide for Employers.

CMS Resources:

  • Prescription Drug Data Collection Reporting page
  • Prescription Drug Data Collection Reporting Instructions
  • Prescription Drug Data Collection FAQs

 

How Carriers Will Handle Reporting

CARRIER REPORTING
Fully Insured
REPORTING
Self/Level Funded
EMPLOYER SURVEYS RESOURCES
Aetna,
Banner|Aetna
Carrier will report. Carrier will report. Survey Required: due April 1, 2023
All employers must provide the following: 
  • Average monthly premium paid by members
  • Average monthly premium paid by employer
  • Funding arrangement
  • Issuer name/legal entity
  • Aetna RxDC Reporting Update
  • Aetna RxDC Survey Link

Anthem,
Empire

Carrier will report. Employer must report:
  • D1 Premium and Life Years report
  • Plan List
  • D3-D8 Pharmacy Specific Reports (if pharmacy coverage is not integrated)
Carrier will report:
  • P2 – Group Health Plan List
  • D2 – Spending by Category Reporting
  • D3-D8 Pharmacy Specific Reports (if integrated pharmacy coverage through CarelonRx)
  • Narrative Response applicable to Anthem business
Survey Required: due March 24, 2023
All employers must provide percentage of the contribution paid by employer vs employee.
  • Anthem RxDC overview
  • Anthem RxDC ASO Update
  • Anthem RxDC Survey Notice
  • Survey Link for Employers
Blue Cross Blue Shield of Arizona Carrier will report. Carrier will report. No survey has been announced
  • BCBSAZ RxDC overview
Blue Shield of California Carrier will report. Varies; refer to the Reporting Grid. Survey Required: due March 16, 2023
All employers must provide contribution values based on their group size and pharmacy benefits; this may be represented as percentage of premium, or as total dollar contribution amount. 
  • Blue Shield Reporting Update
  • Blue Shield Survey/Intake Form
  • Blue Shield D1 Reporting FAQs 
  • Blue Shield CAA page
CareFirst BCBS Employer must report:
  • D1 Premium and Life Years report
  • Plan List
Carrier will report:
  • P2 – Group Health Plan List
  • D2 – Spending by Category Reporting
  • Narrative Response applicable to CareFirst business
Employer must report:
  • D1 Premium and Life Years report
  • Plan List
Carrier will report:
  • P2 – Group Health Plan List
  • D2 – Spending by Category Reporting
  • Narrative Response applicable to CareFirst business
No survey is required
  • CareFirst Reporting Update
  • CareFirst Submission Chart
  • Reporting FAQs
Cigna Carrier will report. Carrier will report. No survey has been announced
  • Cigna RxDC overview
Cigna + Oscar Carrier will report. n/a No survey has been announced
  • C+O RxDC overview
Cigna Administered by Oscar Carrier will report. n/a No survey has been announced
  • CabO RxDC overview
EmblemHealth Carrier will report. Carrier will report. No survey has been announced
  • EmblemHealth RxDC overview
  • EmblemHealth CAA page
Florida Blue Carrier will report. Carrier will report. Survey Required: due April 1, 2023
Calendar year premiums paid by employer and employee. Additional information is for self-insured groups.
  • Florida Blue RxDC overview
  • Survey Link
FHCP Carrier will report. n/a Survey Required: due March 31, 2023
The survey is only be sent to groups where the necessary information was not collected at last renewal.
  • FHCP RxDC overview
  • FHCP Survey Form
Health Net Carrier will report. n/a No survey has been announced
  • Health Net RxDC overview
Healthfirst Carrier will report. Carrier will report. No survey has been announced -
Humana Carrier will report. Varies; refer to Humana's Prescription Drug Data Guide. No survey has been announced
  • Humana RxDC overview
  • Humana Prescription Drug Data Guide.
Kaiser Permanente Carrier will report. Carrier will report. Survey Required: due April 3, 2023
All employers must provide the following: 
  • Average monthly premium paid by members
  • Average monthly premium paid by employer
  • Employer Form 5500 Plan Number (if applicable)
  • Kaiser RxDC overview
  • Survey Link
Oscar Carrier will report. n/a No survey has been announced
  • Oscar RxDC overview
Sharp Health Plan Carrier will report. n/a No survey has been announced
  • Sharp RxDC overview
Sutter Health Plus Carrier will report. n/a Survey closed March 1, 2023
  • Sutter RxDC overview
  • Sutter RxD Survey Notice
  • Survey Link for Employers
UnitedHealthcare,
Oxford
Carrier will report. Varies; refer to the CAA UHC Approach to Pharmacy Benefits and Costs Reporting Guide

Survey closed March 10, 2023

  • UHC RxDC overview
  • UHC RxD Survey Notice
  • Survey Link for Employers
  • Survey Tips Flyer
  • UHC CAA FAQs
Western Health Advantage Carrier will report.

Small employers should review their Group Service Agreement Cover Sheet (renewal doc) to ensure contribution values are correct. This will be used for WHA reporting.

Large employers will be contacted by WHA to confirm contribution values.
n/a No survey has been announced
  • WHA RxDC overview

 

Other Carriers:

  • The following are administrators and not responsible for reporting: CaliforniaChoice, Covered California, and HealthPass. Employers should follow the enrolled carrier(s) for how reporting will be handled.
  • MediExcel Health Plan is exempt from reporting.

 

Carrier Articles Related to RxDC

RxDC

03/20/2023

Aetna Prescription Drug Data (RxDC) Survey Requirement

Data collection requirement for all Aetna small group plan sponsors Prescription drug data reporting submission due 4/1 Prescription Drug Data Collection (RxDC) reporting for the 2022 reference ...
03/15/2023

RxDC Information At Your Fingertips!

RxDC Information At Your Fingertips! Our broker partners and their clients have many questions on this latest topic and Amwins Connect website can assist you with answers. Brokers should be info...
03/14/2023

Western Health Advantage and Prescription Drug Data Collection Reporting (RxDC) Requirements

The RxDC is a data report required under section 204 of the CAA. This report requires health insurance issuers and group health plans to submit information about prescription drug and health care spen...
03/14/2023

Anthem Blue Cross RxDC Premium Reporting for Employers

Important premium information needed for the 2023 Prescription Drug Data Collection submission Anthem needs help collecting monthly average premium information required for Prescription Drug Data C...
03/09/2023

Kaiser Permanente®: Act Now - Form Completion Required by Employers for Federal Reporting Under CAA

As part of pharmacy reporting under the Consolidated Appropriations Act (CAA), 2021, Kaiser Permanente is required to submit information on prescription drugs and healthcare spending to CMS. To help e...
03/08/2023

Anthem Exception for Prescription Drug Data Reporting (RxDC) on ASO Groups

CAA RxDC D1 reporting update: Anthem can file on your ASO clients’ behalf As follow up to the January notice “Changes to 2023 CAA RxDC reporting for self-funded groups,” this week Anthem is letting...
02/23/2023

Cigna Request Information For Client Reporting

In compliance with the Consolidated Appropriations Act, Title II, Section 204, Cigna will produce medical and/or pharmacy spending reports annually for both fully insured and self-funded (ASO) clients...
02/22/2023

Blue Shield of California Pharmacy Drug Cost Reporting (RxDC): Collecting D1 Premium Data

Last month, brokers and groups received an email communication stating they would be responsible for submitting D1 Premium and Life year data (D1) to the Centers for Medicare and Medicaid Services (CM...
02/17/2023

Rx Reporting - Round Two! (Sorry, you can't ignore it this time.)

Rx Reporting – Round Two! (Sorry, you can’t ignore it this time.) February 15, 2023 We’ve made it through the first round of prescription drug reporting (a/k/a RxDC reporting) required by the Co...
02/16/2023

Sutter Health Plus RxDC Premium Reporting for Employers

The Consolidated Appropriations Act of 2021 (Section 204) requires insurance companies and employer-based health plans to submit information to the federal government about: Spending on prescrip...
02/13/2023

Cigna and Prescription Drug and Health Care Spending Report

Health plans (which include employers that offer medical benefit plans to their employees) must report information on plan medical costs and prescription drug spending to the Secretaries of the U.S. D...
02/10/2023

Anthem Changes to Prescription Drug Data Collection Reporting (RxDC) for Self-Funded Groups

Changes to 2023 CAA RxDC Reporting For Self-Funded Groups In response to recent federal regulatory guidelines, Anthem is changing the submission process for Prescription Drug Data Collection (RxDC)...

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