Loading...Loading...September 24, 2024
The Consolidated Appropriations Act, 2021, requires health insurance issuers to report plan members’ prescription drug and health care spending data to the Centers for Medicare & Medicaid Services (CMS) each year. Called Prescription Drug Data Collection (RxDC), the reporting for each year is due to CMS on June 1 of the following year.
We have established a process for including in the reporting we submit to CMS groups that terminate their coverage with us in 2024. We will include only the RxDC information for the benefits we administered during months in 2024 when a group’s coverage with us was active. Another entity will need to submit RxDC information to CMS for other months.
We mail letters about our RxDC reporting process to groups after they terminate their coverage. These letters explain information they’ll need to provide us in order to be included in our reporting for the year.
If you want us to include all data for your Regence benefits in our reporting, we need to collect information that we don’t hold in our systems:
- Fully insured groups must provide us the total dollar amount for Regence medical premium collected from enrolled employees during the months their coverage was active in 2024.
- Self-funded groups must provide us the average monthly premium (or premium equivalents) that the group and its employees paid, along with a D1 (premium and life years) file for the benefits we administered during the months their coverage was active in 2024.
Although we also include self-funded groups in our RxDC reporting each year as a courtesy, it is each self-funded group’s obligation to ensure reporting is submitted to CMS—either by us, another entity or themselves. We include only self-funded groups that provide us the required information in our reporting.
Questions? Please email RxDCQuestions@regence.com.