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Cigna and Prescription Drug and Health Care Spending Report

Feb 13, 2023
Category
Carrier News

Health plans (which include employers that offer medical benefit plans to their employees) must report information on plan medical costs and prescription drug spending to the Secretaries of the U.S. Department of Health and Human Services (HHS), Department of Labor, and Department of the Treasury for reporting years 2020 and 2021 by 12/27/22. For subsequent reporting years, clients must report the information by 6/1 annually.

The primary intent of the data collection is to provide valuable information to policy makers about competition and market concentration in the pharmaceutical and health care industries. The collected data will be used in a report published on the HHS website 18 months after initial data submission, and then every two years thereafter; the report will offer information on prescription drug pricing trends and employer contribution to health insurance premiums.

What Cigna is Doing

  • Cigna will produce medical and/or pharmacy spend reporting annually for both fully insured and self-funded (ASO) clients.
  • These reports will be provided to the U.S. Departments of Health and Human Services, Department of Labor, and Department of the Treasury.
  • Reports for reporting years 2020 and 2021 will be delivered by 12/27/22. For reporting year 2022 and beyond, reports will be provided by 6/1 of the following year.
  • These aggregated spend data reports for U.S. Commercial clients will be available to clients via CignaforEmployers.com.
  • The reports submitted by 12/27/22 will not incorporate any data from clients or other external parties nor any data that is not maintained by Cigna.
  • Data will not be provided at the client level.
  • Federal guidance issued on 6/28/22 does not change our submission approach; client action is not required for reports submitted by 12/27/22. Additional communication regarding reports to be submitted annually beginning 6/30/23 will be provided by December 2022.
Tags
Cigna
RxDC

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