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The RxDC reporting provision of the Consolidated Appropriations Act (CAA) requires reports on drug utilization and spending trends to be submitted to U.S. Department of Health and Human Services. Reports are due annually by June 1.
View the Amwins Connect Health Cost Transparency Guide for Employers.
CMS Resources:
- Prescription Drug Data Collection Reporting page
- Prescription Drug Data Collection Reporting Instructions
- Prescription Drug Data Collection FAQs
How Carriers Will Handle Reporting
| CARRIER | REPORTING Fully Insured | REPORTING Self/Level Funded | EMPLOYER SURVEYS | RESOURCES |
|---|---|---|---|---|
| Aetna, Banner|Aetna | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | |
| Allstate Benefits | n/a | Details pending for 2024 | Survey not required. | - |
| Anthem | Carrier will report. | Employer must report:
Carrier will report:
| Survey typically required: not yet announced for 2025 | |
| Blue Cross Blue Shield of Arizona | Carrier will report. | Carrier will report. | Survey not required. | - |
| Blue Shield of California | Carrier will report. | Varies; refer to the Reporting Grid. | Survey typically required: not yet announced for 2025 | |
| CareFirst BCBS | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | |
| Cigna | Carrier will report. | Carrier will report. | Survey not required. | - |
| Cigna + Oscar | Carrier will report. | n/a | Survey not required. | - |
| Cigna Administered by Oscar | Carrier will report. | n/a | Survey not required. | - |
| ConnectiCare | Carrier will report. | n/a | Survey typically required: not yet announced for 2025 | |
| EmblemHealth | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | |
| Florida Blue | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | |
| FHCP | Carrier will report. | n/a | Survey typically required: not yet announced for 2025 | |
| Health Net | Carrier will report. | n/a | Survey not required. | |
| Healthfirst | Carrier will report. | Carrier will report. | Survey not required. | - |
| Humana | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | |
| Kaiser Permanente | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | |
| Sharp Health Plan | Carrier will report. | n/a | Survey typically required: not yet announced for 2025 | |
| Sutter Health Plus | Carrier will report. | n/a | Survey typically required: not yet announced for 2025 | |
| UnitedHealthcare, Oxford | Carrier will report for groups using OptumRx as PBM. Groups with other PBMs (including OptumRx Direct) should refer to the CAA UHC Approach to Pharmacy Benefits and Costs Reporting Guide | Carrier will report for groups using OptumRx as PBM. ASO groups and groups with other PBMs (including OptumRx Direct) should refer to the CAA UHC Approach to Pharmacy Benefits and Costs Reporting Guide | Survey typically required: not yet announced for 2025 | |
| Western Health Advantage | Carrier will report. Small employers should review their Group Service Agreement Cover Sheet (renewal doc) to ensure contribution values are correct. This will be used for WHA reporting. Large employers will be contacted by WHA to confirm contribution values. | n/a | Survey not required. | - |
Other Carriers:
- The following are administrators and not responsible for reporting: CaliforniaChoice, Covered California, and HealthPass. Employers should follow the enrolled carrier(s) for how reporting will be handled.
- MediExcel Health Plan is exempt from reporting.
Carrier Articles Related to RxDC
RxDC
01/06/2025
January 14, 2025 Compliance Webinar Series Invitation
January 14, 2025 Compliance Webinar InvitationFederal Benefits Reporting RequirementsAmwins Connect Insurance Services continues to be a proud sponsor of Summit Employee Benefits Online Education. Thi...
07/23/2024
Health Net | RxDC Report Filing Completed in May 2024
Health Net successfully filed the RxDC report for Oregon and California Small and Large groups on May 30, 2024.
06/03/2024
Blue Shield of California: Confirmation of RxDC Report Submission
Data submitted is for the preceding year, 2023. Blue Shield will also reach out to groups, informing them of the data submission.
05/07/2024
RxDC Reporting is Due June 1, 2024
RxDC Reporting is due to CMS by June 1, 2024 2023 Prescription Drug Data reporting is due June 1, 2024. As of the publication of this article, reporting of Rx Data is due to CMS in a little over...
04/11/2024
Blue Shield of CA | Prescription Drug Cost Reporting - Deadline to Submit D1 Data: April 19, 2024
Blue Shield of California is collecting D1 Premium Contribution data as part of the Consolidated Appropriations Act, Section 204 (2021)– Prescription Drug Cost Reporting regulation, on behalf of Blue ...
04/04/2024
RxDC Resources at Amwins Connect
RxDC Resources at Amwins Connect As we get closer to the deadline, you are probably receiving questions from your clients asking you what the carriers are doing or what are they not doing in order ...
03/18/2024
Blue Shield of CA | Improved Process for D1 Premium Reporting - RxDC Mandate
Groups and/or their brokers without Employer Connection access, including active groups, termed groups, and Covered California Small Business groups, can submit required information via the Prescripti...
03/18/2024
Sharp Health Plan Prescription Drug Data Collection Reporting (RxDC) Requirements
Employers should submit the requested information by April 19, 2024.
03/13/2024
Aetna Prescription Drug Data (RxDC) Collection Requirement
Aetna will reach out to groups via email, starting on Friday, March 15th. Groups must response with the requested information by April 12.
02/24/2024
Webinar Replay: RxDC Reporting Round 3
RxDC Reporting Round 3 January 31, 2024 Another round of Rx reporting is just around the corner. As we have started seeing communications from carriers and TPAs requesting data for the Rx report...
02/22/2024
UPDATE - CA | Kaiser Permanente® Form Completion Required By Employers Under CAA
Kaiser Permanente has submitted all required data for all groups (both fully insured and self-funded) for calendar years 2020, 2021, and 2022. For the 2023 calendar year, Kaiser Permanente plans to...
02/07/2024
