Covered CA for Small Business sent the following partner alert on April 11, 2023, on the RxDC reporting requirements.
Consolidated Appropriations Act, Section 204 Pharmacy Reporting
“Under Section 204 (of Title II, Division BB) of the Consolidated Appropriations Act, 2021 (CAA), insurance companies and employer-based health plans must submit information about prescription drugs and health care spending. This data submission is called the RxDC report.” Read full CMS overview here.
Covered California for Small Business (CCSB) serves as an administrator of our participating Health Plan Issuers and is not an insurance company nor an employer-based health plan. Therefore, CCSB is not subject to RxDC data collection requirements on behalf of our employer groups. We have however been actively engaged with our Health Plan Issuers to understand their approach to meeting the RxDC reporting requirements. Please find below a summary of approaches taken by our three plans. If you have further questions, we encourage you to reach out to the Health Plan Issuers directly.
Blue Shield of California (800) 559-5905
Blue Shield of California issued a Broker Alert detailing instructions for the submission of group data via an intake form. The deadline for the submission of this form was March 31st. Employer groups who missed the deadline are now responsible for submitting their data directly to CMS by June 1, 2023.
Kaiser Permanente (800) 464-4000
Kaiser Permanente is compiling and submitting the required data on behalf of their employer groups.
Sharp Health Plan (800) 359-2002
Sharp Health Plan will be contacting their employer groups directly to obtain the required information. In addition, they will be sending a broker and employer alert informing all brokers and CCSB employers of the RxDC reporting requirement.
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