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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
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:
|
|
|
Anthem, |
Carrier will report. | Employer must report:
|
Survey Required: due March 24, 2023 All employers must provide percentage of the contribution paid by employer vs employee. |
|
| Blue Cross Blue Shield of Arizona | Carrier will report. | Carrier will report. | No survey has been announced | |
| 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. |
|
| CareFirst BCBS | Employer must report:
|
Employer must report:
|
No survey is required | |
| Cigna | Carrier will report. | Carrier will report. | No survey has been announced | |
| Cigna + Oscar | Carrier will report. | n/a | No survey has been announced | |
| Cigna Administered by Oscar | Carrier will report. | n/a | No survey has been announced | |
| EmblemHealth | Carrier will report. | Carrier will report. | No survey has been announced | |
| 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. |
|
| 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. |
|
| Health Net | Carrier will report. | n/a | No survey has been announced | |
| 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 | |
| Kaiser Permanente | Carrier will report. | Carrier will report. | Survey Required: due April 3, 2023 All employers must provide the following:
|
|
| Oscar | Carrier will report. | n/a | No survey has been announced | |
| Sharp Health Plan | Carrier will report. | n/a | No survey has been announced | |
| Sutter Health Plus | Carrier will report. | n/a | Survey closed March 1, 2023 | |
| UnitedHealthcare, Oxford |
Carrier will report. | Varies; refer to the CAA UHC Approach to Pharmacy Benefits and Costs Reporting Guide |
Survey closed March 10, 2023 |
|
| 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 |
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
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