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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
  • CMS RxDC HIOS Module User Manual

 

How Carriers Will Handle Reporting

CARRIERREPORTING
Fully Insured
REPORTING
Self/Level Funded
EMPLOYER SURVEYSRESOURCES
Aetna,
Banner|Aetna
Carrier will report.Carrier will report.Survey required: due by March 31, 2025
  • Aetna RxDC Overview
  • Survey Link
Allstate Benefitsn/aDetails pending for 2024Survey not required.-
AnthemCarrier 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 by March 28, 2025

Anthem sent emails directly to the employers with information and the link to the survey.

  • Anthem RxDC Overview

     

     

Blue Cross Blue Shield of ArizonaCarrier will report.Carrier will report.Survey not required.-
Blue Shield of CaliforniaCarrier 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

  • Blue Shield of California RxDC Overview
  • Prescription Healthcare Spending Survey FAQs
CareFirst BCBSCarrier will report.Carrier will report.Survey required: due by May 12, 2025
  • CareFirst RxDC Overview
  • Broker Portal
  • Employer Portal
CignaCarrier will report.Carrier will report.Survey not required.-
Cigna + OscarCarrier will report.n/aSurvey not required.-
Cigna Administered by OscarCarrier will report.n/aSurvey not required.-
ConnectiCareCarrier will report.Carrier will report.

Survey required: due by May 9, 2025

ConnectiCare will email a survey link to employers in mid-April.

  • ConnectiCare RxDC Survey Notice
  • ConnectiCare CAA page
EmblemHealthCarrier will report.Carrier will report.

Survey required: due by May 9, 2025

EmblemHealth will email a survey link to employers in mid-April.

  • EmblemHealth RxDC Survey Notice
  • EmblemHealth CAA page
Florida BlueCarrier will report.Carrier will report.Survey typically required: not yet announced for 2025 -
FHCPCarrier will report.n/aSurvey typically required: not yet announced for 2025 -
Health NetCarrier will report.n/aSurvey not required.
  • Health Net RxDC overview
HealthfirstCarrier will report.Carrier will report.Survey not required.-
Kaiser PermanenteCarrier will report.Carrier will report.Survey required: survey will be available until March 31, 2025
  • Kaiser RxDC overview
Sharp Health PlanCarrier will report.n/aSurvey required: due by April 18, 2025
  • Sharp RxDC overview
  • Survey Link
  • RxDC FAQs
Sutter Health PlusCarrier will report.n/aSurvey required: due by March 1, 2025
  • Sutter RxDC overview
  • Survey Link
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.

  • UHC RxDC overview
  • Employer Worksheet for Gathering RFI Data
  • Employer Training for RFI Tool
Western Health AdvantageCarrier will report.n/aSurvey 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

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

RxDC Reporting is Due June 1, 2024

RxDC Reporting is due to CMS by June 1, 2024 2023 Prescription Drug Data reporting is due June 1, 2024. As of the publication of this article, reporting of Rx Data is due to CMS in a little over...

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