Data Collection (RxDC) Requirement for All Aetna Small Group Plan Sponsors

Prescription drug data reporting submission due 4/1

Prescription Drug Data Collection (RxDC) reporting for the 2022 reference year is required to be sent to the departments of Health and Human Services, Labor and Treasury no later than 6/1/2023. This is in response to requirements in the 2021 Consolidated Appropriations Act and implementing regulations.

Aetna is committed to complying with all legal and regulatory requirements affecting their business operations and their customer's health benefits. The following is how Aetna is helping their Small Group plan sponsors submit these reports.

The submission process

1. In a few days, Aetna will send instructions to all Small Group plan sponsors.
2. They should fill out this RxDC Plan Sponsor Data Collection Form with the required data by 4/1/2023*. The required data includes the following:
   1. Average monthly premium paid by members
   2. Average monthly premium paid by employer
   3. Funding arrangement 
   4. Issuer name/legal entity
3. Aetna can then use the data to submit on behalf of your client.

*A plan sponsor will need to submit a form for each product based on Aetna’s legal entity. For CA HMO plans, the plan sponsor will submit a form for all their Aetna HMO plans under Aetna Health of California as their issuer/legal entity. For non-HMO plans, the plan sponsor will submit a form for all CA OAMC/PPO plans under Aetna Life Insurance Company as their issuer/legal entity.

Process for submissions that are missing or incomplete by 4/1/2023

Aetna will submit the report without the required plan sponsor data. Failure to respond will impact Aetna's ability to accurately report on the plan sponsor’s behalf, and Aetna will not be responsible for any liability associated with the inaccurate report. 

Please note, if your clients don't complete this form, Aetna will submit on their behalf but it will be incomplete. Per the RxDC regulations, your clients would then need to submit the information directly to CMS by 6/1/23.

What you can do: Help your clients gather and report the data.

Aetna is available to help! If you have any questions or want to discuss this process, please contact your Aetna representative.