Employee Benefits

Your Guide to RxDC Collection and Reporting

March 30, 2023

The Consolidated Appropriations Act of 2021 (CAA) requires insurers and employers who sponsor group health plans to submit annual reports on prescription drug use and healthcare spending by June 1. To assist in this process, known as “RxDC reporting,” Alera Group has issued a comprehensive whitepaper, The Five W’s and One H: Pharmacy Data Collection Under the CAA.

Most employers sponsoring a group plan are responsible for compliance with CAA requirements under the Internal Revenue Code (the Code), the Employee Retirement Security Act of 1974 (ERISA) and the Public Health Services Act (PHSA). The whitepaper includes such essential information as:

  • Why RxDC reporting is required;

  • Who is required to report;

  • When information must be reported;

  • What must be included in reporting;

  • Where submissions are made;

  • How requirements are enforced and employers can get additional help.

In addition, you’ll find:

  • Links to Centers for Medicare & Medicaid Services (CMS) reporting instructions, templates and terms;

  • Responsibilities of Reporting Entities;

  • Examples of employer filing procedures;

  • Guidance on data files and aggregation;

  • Step-by-step instructions on narrative response;

  • A copy of CMS’s RxDC Health Insurance Oversight System (HIOS) Access Guide.

In addition to using the extensive information in the Alera Group whitepaper, employers who sponsor a group health plan should pay close attention to communications from their insurance carriers, third-party administrators (TPAs) and/or pharmacy benefit managers (PBMs) with specific action items and due dates. In the meantime, we’re confident you’ll find The Five W’s and one H an informative and highly useful guide.