News & Updates
Section 204 of the Consolidated Appropriations Act, 2021 (CAA) requires insurance companies and employer-based health plans to submit information about prescription drugs to the Centers for Medicare and Medicaid Services (CMS) on behalf of the Department of Health and Human Services, the Department of Labor, the Department of Treasury, and the Office of Personnel Management beginning December 27, 2022. These requirements are referred to as RxDC. The Rx stand for prescription drug and the DC stands for data collection.
What information do insurance companies and employers submit to CMS?
How will this information be used?
The data submitted by insurance companies and employer-based health plans will help to:
What do these requirements mean for your groups?
Insurers, TPAs, and PBMs will control most of this information. The insurance company will likely handle all of the reporting requirements for fully insured clients, however, the carrier may need to ask the group for premium contributions in order to file. Self insured groups should work with their TPA or PBM.
Groups may want to update their contracts with the carrier. Some carriers will be submitting the required information on behalf of their fully insured clients then they will provide confirmation once reporting has been submitted.
CMS Resources:
HIOS Manuals
For questions, please contact your B&P Sales Rep - 888.722.3373.
The information contained herein is for informational purposes only and is not intended as legal or tax advice.