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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
- CMS RxDC HIOS Module User Manual
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 by March 31, 2025 | |
| Allstate Benefits | n/a | Details pending for 2024 | Survey not required. | - |
| Anthem | Carrier will report. | Employer must report:
Carrier will report:
| Survey required: due by March 28, 2025 Anthem sent emails directly to the employers with information and the link to the survey. | |
| Blue Cross Blue Shield of Arizona | Carrier will report. | Carrier will report. | Survey not required. | - |
| Blue Shield of California | Carrier will D2 for all groups and D3-D8 for groups with prescription drug under a Blue Shield health benefit plan. | Varies; refer to the Reporting Grid. | Survey required: due by April 19, 2025 Groups or brokers with access to Employer Connection are encouraged to complete the survey at the above link. All others can submit required information at Prescription Drug & Healthcare Spending Survey using their Group ID and the web key: #25yr24 | |
| CareFirst BCBS | Carrier will report. | Carrier will report. | Survey required: due by May 12, 2025 | |
| Cigna | Carrier will report. | Carrier will report. | Survey not required. | - |
| Cigna + Oscar | Carrier will report. | n/a | Survey not required. | - |
| Cigna Administered by Oscar | Carrier will report. | n/a | Survey not required. | - |
| ConnectiCare | Carrier will report. | Carrier will report. | Survey required: due by May 9, 2025 ConnectiCare will email a survey link to employers in mid-April. | |
| EmblemHealth | Carrier will report. | Carrier will report. | Survey required: due by May 9, 2025 EmblemHealth will email a survey link to employers in mid-April. | |
| Florida Blue | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | - |
| FHCP | Carrier will report. | n/a | Survey typically required: not yet announced for 2025 | - |
| Health Net | Carrier will report. | n/a | Survey not required. | |
| Healthfirst | Carrier will report. | Carrier will report. | Survey not required. | - |
| Kaiser Permanente | Carrier will report. | Carrier will report. | Survey required: survey will be available until March 31, 2025 | |
| Sharp Health Plan | Carrier will report. | n/a | Survey required: due by April 18, 2025 | |
| Sutter Health Plus | Carrier will report. | n/a | Survey required: due by March 1, 2025 | |
| UnitedHealthcare, Oxford | Carrier will report for groups using OptumRx as PBM. Groups with other PBMs (including OptumRx Direct) should refer to the CAA UHC Approach to Pharmacy Benefits and Costs Reporting Guide | Carrier will report for groups using OptumRx as PBM. ASO groups and groups with other PBMs (including OptumRx Direct) should refer to the CAA UHC Approach to Pharmacy Benefits and Costs Reporting Guide | Survey required: due by March 31, 2025 Survey is located in eServices. Groups can complete the employer worksheet prior to logging in. | |
| Western Health Advantage | Carrier will report. | n/a | Survey not required. 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. | - |
Other Carriers:
- CaliforniaChoice is providing requested data to all carriers and the carriers will report the RxDC information for the employers and plans. There is no additional action needed by CaliforniaChoice groups.
- The following are administrators and not responsible for reporting: 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
04/24/2025
RxDC Reporting is Due June 1, 2025
RxDC Reporting is Due June 1, 2025 Annual RxDC reporting is required by June 1 of each year. Reporting for the data from 2024 will be due June 1, 2025. The reporting consists of a plan file (P2), eigh...
03/28/2025
Sharp Health Plan RxDC Reporting Form, 2025
Submissions due April 18, 2025.
03/24/2025
Blue Shield | Rx Healthcare Spending Survey Available Now, Due April 19, 2025
Blue Shield of California is collecting D1 Premium Contribution data as part of the Consolidated Appropriations Act, Section 204 (2021)–Survey deadline April 19, 2025.
02/20/2025
Webinar Replay: RxDC Reporting
RxDC Reporting - Round 4 This is the 4th submission of Prescription Drug data required to be provided to CMS by June 1, 2025 for the 2024 calendar year.This webinar will revisit and review the require...
02/20/2025
Blue Shield | Annual (RxDC) Prescription Healthcare Spending Survey
Blue Shield groups that miss the RxDC survey deadline will not be included in Blue Shield’s filing and may be subject to non-compliance if they do not report the required data directly to the CMS on t...
02/05/2025
Reminder of RxDC Resources at Amwins Connect
RxDC Resources at Amwins ConnectYou are probably receiving questions from your clients asking you what the carriers are doing or what are they not doing in order to meet the compliance deadline to CMS...
02/03/2025
2025 UnitedHealthcare/Oxford Approach to CAA Prescription Drug (RxDC) Reporting
UnitedHealthcare and Oxford fully insured and self-funded/level funded groups must complete the online tool for CAA RxDC reporting between February 1, 2025, and March 31, 2025.
01/30/2025
2025 Aetna Prescription Drug Data (RxDC) Collection Requirement
Aetna will reach out to groups via email, starting on Friday, January 31, 2025. Groups must respond with the requested information by March 31.
01/06/2025
January 14, 2025 Compliance Webinar Series Invitation
January 14, 2025 Compliance Webinar InvitationFederal Benefits Reporting RequirementsAmwins Connect Insurance Services continues to be a proud sponsor of Summit Employee Benefits Online Education. Thi...
07/23/2024
Health Net | RxDC Report Filing Completed in May 2024
Health Net successfully filed the RxDC report for Oregon and California Small and Large groups on May 30, 2024.
06/03/2024
Blue Shield of California: Confirmation of RxDC Report Submission
Data submitted is for the preceding year, 2023. Blue Shield will also reach out to groups, informing them of the data submission.
05/07/2024
