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:

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 closed April 1	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 closed March 24	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 closed March 31	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
ConnectiCare	Carrier will report.	n/a	Survey Required: due May 18 All employers must provide the following: Average percent of medical premium paid by employer Average percent of medical premium paid by employees	ConnectiCare RxDC overview Survey Link
EmblemHealth	Carrier will report.	Carrier will report.	Survey Required: due May 18 All employers must provide the following: Average percent of medical premium paid by employer Average percent of medical premium paid by employees	EmblemHealth RxDC overview Survey Link EmblemHealth CAA page
Florida Blue	Carrier will report.	Carrier will report.	Survey closed April 1	Florida Blue RxDC overview Survey Link
FHCP	Carrier will report.	n/a	Survey closed March 31	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 closed April 3	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	Survey closed May 1	Sharp RxDC overview Survey Link for Employers
Sutter Health Plus	Carrier will report.	n/a	Survey closed March 1	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	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

05/19/2023

Update on Employer Responsibilities for the Upcoming RxDC Reporting Due June 1, 2023

Update on Employer Responsibilities for the Upcoming RxDC Reporting due June 1, 2023 May 2023 Many employers received an email from their carrier or TPA (for Self-Insured plans) requesting that ...

05/13/2023

Webinar Replay: RxDC Reporting - Do Employers Have To Submit Their Own D1 File?

RxDC Reporting - Do Employers Have to Submit Their Own D1 File? May 10, 2023 Many employers, especially those with fully-insured plans, were surprised when their carrier or TPA requested certain...

05/12/2023

UnitedHealthcare to Meet CAA Prescription Drug Data Collection (RxDC) Deadline

UnitedHealthcare is on target to submit Pharmacy Benefits and Costs Data (RxDC) by June 1, 2023

05/10/2023

Kaiser Permanente®: Releases Update on COVID-19 Coverage and CAA RxDC Reporting

In March, Kaiser contacted their current customers and brokers to request group specific information required for them to complete aggregated reports for pharmacy reporting under the Consolidated Appr...

04/12/2023

Covered California Small Business: Consolidated Appropriations Act, Section 204 Pharmacy Reporting

Covered California for Small Business (CCSB) serves as an administrator of their participating Health Plan Issuers and is not an insurance company nor an employer-based health plan. Therefore, CCSB is...

03/28/2023

Sharp Health Plan Prescription Drug Data (RxDC) Survey Requirement

Employers should submit their information by May 1, 2023. Understanding the RxDC Report Under Section 204 of the Consolidated Appropriations Act, insurance companies and employer-based health pl...

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...

View All