2024 RxDC Reporting Requirements
The Prescription Drug Data Collection (RxDC) report is a requirement under the Consolidated Appropriations Act, 2021 (CAA). This report mandates that insurance companies and employer-based health plans submit detailed information about prescription drugs and healthcare spending to the Centers for Medicare and Medicaid Services (CMS) on behalf of the Departments of Health and Human Services, Labor, and Treasury.
What is RxDC Reporting?
The RxDC report collects data on:
- Spending on prescription drugs and healthcare services
- Prescription drugs that account for the most spending
- Drugs prescribed most frequently
- Prescription drug rebates from manufacturers
- Premiums and cost-sharing paid by patients
This data helps identify major drivers of prescription drug and healthcare spending, understand the impact of drug rebates on premiums and out-of-pocket costs, and promote transparency in drug pricing.
Who Submits RxDC Reports
For fully insured groups, the insurance carrier is typically the one that will submit the data to CMS. However, they may require specific information from the employers to complete the report. This often involves sending out surveys or forms to gather necessary data that the carriers do not have. Employers should be prepared to provide this information promptly to ensure compliance with the reporting deadlines.
Self-insured groups should work with their carrier or TPA to determine who will be submitting the required information to CMS.
Carrier Responses
The following table shows how each carrier is handling the RxDC submission and whether they are asking for information from their groups.
| Carrier | Communications | Requesting ER & EE premiums as $ or %? | Who can submit? | Deadline |
|---|---|---|---|---|
| Aetna | 1/31/25 emails start going to groups | Dollar amount (total) | Sent to group | Online form due 3/31/25, group should use the link in the email from Aetna which prepopulates the form with the group's information |
| Anthem Blue Cross | 2/12/25 BrokerHub news | Percentage | Does not specify | Online form due 3/19/25 |
| Blue Shield | Email to brokers on 2/19/25 | Percentage | Employer or broker | Online form due 4/19/25 |
| CaliforniaChoice | Health plans will submit on behalf of CalChoice groups, no action needed from groups | n/a | n/a | n/a |
| Cigna + Oscar | Cigna will be submitting the required reporting, no action needed from groups | n/a | n/a | n/a |
| Covered CA for Small Business | Blue Shield is requesting information from CCSB groups with Blue Shield coverage. Kaiser and Sharp will not be requesting info from CCSB groups. | Percentage (Blue Shield) | Employer or broker (Blue Shield) | Blue Shield: Online form due 4/19/25 Use web key: #25yr24 Blue Shield Group # is on CCSB Employer Dashboard under Enrolled Medical Plans section |
| Health Net | Confirmed on 1/31/25 that they will meet regulatory obligations and will not be asking groups for anything | n/a | n/a | n/a |
| Kaiser Permanente | Emails sent to groups | Dollar amount (monthly) | Employer or broker | Online form due 3/31/25 |
| Sutter Health Plus | Emails sent to groups Notice posted to website | Dollar amount (total) | Employer or broker | Online form due 3/1/25 |
| UnitedHealthcare | 2/3/25 emails sent to groups and brokers | Dollar amount (monthly) | Employer or broker | Online form on employer portal due 3/31/25 |
Please encourage your groups to submit their information to their carriers prior to the carrier deadline.
If the group does not submit their information to the carrier prior to the carrier deadline, then they will need to submit their information directly to CMS.
See our Prescription Drug Data Collection (RxDC) webpage (login required) for more information, including answer to frequently asked questions.