Loading...Loading...January 28, 2025
Each year we contact each of our groups about the Consolidated Appropriations Act, 2021. This law mandates health insurance companies and some employers send data to the Centers for Medicare & Medicaid Services annually. The information is called Prescription Drug Data Collection (RxDC) and includes:
- How much is spent on prescription medicines
- How much is spent on medical care
- How much is charged for premiums
CMS encourages us to work together to submit data in a single file for each plan. As a courtesy, we can submit your RxDC data on your behalf for the benefits that we administered in 2024. To enable you to provide us the necessary data, we’ve created a data collection form with detailed instructions that you can access through Employer Center beginning March 5, 2025.
Here’s the data we need to fulfill RxDC reporting on your behalf:
- Fully insured groups must provide the dollar amount of premium they collected from all enrolled employees (and their dependents) during the time we administered their benefits in 2024.
- Self-funded groups must provide us the same data they provided for 2021-23: Premium equivalents and a D1 (premium and life years) file for the benefits we administered in 2024.
Employer groups that don’t provide their data to us by April 30, 2025, won’t be included in our 2024 RxDC submission to CMS. These groups will need to self-report their RxDC data independently or through another entity. Self-reporting instructions are available at CMS.gov.
We only submit data for the benefits we administer. Self-funded groups will need to consult with separate entities on reporting of data for carved-out services, including carved-out pharmacy and any premium-based benefits.
Employer Center is our online platform that employer group administrators use to conveniently manage their benefits. If you don’t have access to Employer Center, visit employercenter.regence.com and click Request access to get set up before the data submission deadline.
We’ll provide updates and further instructions about sending your required 2024 RxDC data to us through Employer Center in the coming weeks.
Questions? Please contact your account representative.