Employers should submit their information by May 1, 2023.
Understanding the RxDC Report
Under Section 204 of the Consolidated Appropriations Act, insurance companies and employer-based health plans must submit information regarding prescription drug benefits and health care spending to the Centers for Medicare & Medicaid Services (CMS) by June 1 of each year for the prior year’s coverage. This report is also known as the RxDC Report.
New federal legislation requires employer groups to report on the average monthly premium they and their employees paid the year prior. This information is reported on the D1 Template of the RxDC Report filing.
- Average monthly premium paid by employees (i.e., payroll contribution)
- Average monthly premium paid by the employer group (i.e., total amount of premium paid, minus the employee contribution amounts paid)
- General employer group information (i.e., employer group name, Employer Identification Number [EIN], etc.)
Deadline to submit information
Sharp Health Plan will reach out to employer groups that were enrolled in 2022 to request this information. They will submit the D1 Template on behalf of their employer groups; however, they need information from them in order to report on their behalf. If Sharp does not receive the completed form by May 1, 2023, then the employer group will be responsible for submitting all required data directly to CMS by June 1, 2023. Failure to do so could result in the employer being subject to penalties.
Employers should submit the requested information using the RxDC Employer Reporting Intake Form. The form includes instructions on how to calculate data per CMS’ instructions.
If you have any questions, please check out their FAQ or contact your account manager. We are happy to help!
For more information, please view these resources from CMS.
- CMS RxDC Reporting Instruction Manual (see pages 21-22)
- CMS RxDC Reporting Website