Feb 14, 2025
The Prescription Drug Data Collection (RxDC) reporting provision of the Consolidated Appropriations Act (CAA) requires reports on drug utilization and spending trends be submitted to the U.S. Department of Health and Human Services each year. As a reminder, Anthem is required to include the average monthly premiums paid by members and by employers in the Premium and Life Years (D1) reporting.
The next RxDC report is due by June 1, 2025. Anthem will follow the same process as in prior years and will file on behalf of their fully insured and ASO clients for the benefits Anthem administers and maintain. This includes ASO groups who opt-in to the D1 reporting. In order to submit all required information and ensure reporting accuracy, Anthem will request some information from their clients.
Here is a summary of the communications Anthem will send to Large Group, Small Group, and National Account clients and the actions they will need to take to complete the required RxDC filing.
The week of February 17 – Fully Insured clients
Anthem will email Fully Insured National Account, Large Group, and Small Group commercial clients, as well as clients with Minimum Premium, MEWA, and Anthem Balanced Funding plans. The email will include a link to an online form for these clients to provide the information Anthem needs to complete the filings on their behalf.
Also the week of February 17 – ASO client
D1 opt-in Anthem will email ASO Large Group and National Account clients and provide a link for them to request that Anthem file their 2024 D1 Premium and Life Years report. For those who opt-in, Anthem will submit the aggregated data by market segment on their behalf for the benefits they administer and maintain.
Early June 2025 -- Confirmation of RxDC filing
When the filing is complete, Anthem will publish an article in EmployerAccess Latest News to let clients know. They will also post an article on Broker Hub, Broker Plus app, Producer Toolbox, and Anthem Consultant Hub new channels.
For more information about the Consolidated Appropriations Act RxDC reporting requirements, please visit our CAA/Transparency Resource Center, CMS’ RxDC information page, or contact your Amwins team. We are here to help.
