Division BB, Title II (Section 204) of the Consolidated Appropriations Act, 2021 (CAA)

Prescription Drug Data Collection Reporting (RxDC)

Initial report due Dec. 27, 2022, and then annually every June 1 for prior year’s data.

Group health plans are required to submit data/information annually reflecting prescription drugs and health care spending to the Department of Health and Human Services (HHS), to the Department of Labor (DOL) and the Department of Treasury (The Departments). Data to be reported includes information on drug utilization, spending and rebates, as well as total spending on health care services by type (e.g., hospital, primary care, etc.). Group health plans are required to include information on how rebates from manufacturers impact premiums and out-of-pocket costs, the amount of rebates by therapeutic class, and the amount of rebates for each of the 25 drugs yielding the highest amount of rebates.

The purpose of this data is for HHS to produce a publicly available aggregate report on drug data and trends noted within the 18 months after the first report is received and bi-annually thereafter. No confidential or trade secret information should be included in the data or reporting.

PAI is in the “RxDC Project Implementation” phase. Our first action item is to determine the most appropriate source of the data. Data sources include, but are not limited to:
  • The group health plan’s pharmacy benefit manager (PBM)
  • The group health plan’s medical claims data (maintained in PAI’s claims systems)
  • Fixed costs (such as admin fees and stop loss premiums)
  • The employer group’s health benefit plan “premium equivalent” (such as exact amounts paid by/collected from the member as well as amounts paid by the employer)
PAI developed a Smart Sheet survey to capture this information. Please complete the survey by August 15th.  We will need the information by this date to ensure we are on target to pull and provide data by Dec. 27, 2022. This survey helps PAI establish a source for data that is not presently available to PAI — data for which PAI does not have an identified source (or where the employer group serves as the identified source).

Thank you for your participation,
PAI Compliance
Copyright © 2022 Planned Administrators, Inc., All rights reserved.

Want to change how you receive these emails?
You can update your preferences or unsubscribe from this list.

Email Marketing Powered by Mailchimp