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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.
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