The Consolidated Appropriations Act (CAA) requires that Group Health Plans report various information about their prescription drug costs and spending. The government calls the data submission of information on prescription drugs and spending the “”RxDC Report”. The government will use the data to provide insight into increased spending on prescription drugs with reporting on rebates, total spending and PBM financials.
The reporting responsibility lies with the Group Health Plan sponsor, but TPAs and PBMs recognize that they will have most of the information necessary to submit the required data on behalf on employer-sponsored plans. There are some data elements that neither your PBM nor Diversified Group would currently have in our systems, which will require some coordination with you to collect the necessary information.
The reporting deadline for 2025 is June 1st, which represents the reporting year 2024.
Diversified Action:
Diversified Group will file on behalf of our 2024 medical/rx clients the P2, D1 and D2 files, along with the narrative file. The client’s PBM submit the D3 through D8 file.
The required information we need from plan sponsors is the total annual employee contribution amount for the entire CY 2024. In other words, the total amount of deductions taken from all employees over the course of the year rolled up into one total annual number. This data element is required in order to include a plan sponsor in the file upload.
Within the next few weeks, you will receive a DocuSign that will include an RxDC informational gathering form where you can report the total contribution number to Diversified. Diversified will be submitting the 2024 RxDC data file due June 1, 2025 (for CY 2024) for our clients and former clients that we administered medical/rx for during the 2024 calendar year, provided we receive the required plan sponsor information concerning total annual contributions from the plan sponsor. Please be on the lookout for this request via DocuSign, without this information, Diversified will be unable to file the RxDC on your behalf.
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