RxDC – Annual Deadline Quickly Approaching for  Employer-Sponsored Group Health Plans

The Consolidated Appropriations Act of 2021 (CAA) requires that nearly all group health plans (fully insured, self-funded, and level-funded) report data about prescription drug pricing and health care spending in an effort to promote price transparency and in hopes of encouraging competition to drive drug pricing down.

If your company sponsors a fully insured group health plan, the health insurance company likely will take care of this filing for you (but make sure you confirm in writing).  However, if you have a self-funded or level-funded plan, you will need to ensure that your plan vendor or third party administrator will complete this filing for you.  The best way to do this is to enter into a written agreement (or amend your current agreement) to provide for these services.  The ultimate obligation is on the employer that sponsors the group health plan so if your vendor is not providing this service, you will need to find someone to do this for you or you will need to complete this filing yourself.  If you have not discussed this with your plan vendor, you will need to do so ASAP as many plan vendors have early April deadlines to gather all of the data needed to meet the filing deadline.

The RxDC (which stands for Rx (prescription drugs) DC (data collection) for the 2023 calendar year is due June 30, 2024.  The information to be collected by the government includes general plan information, enrollment and premium data, total health care spending (broken down into categories), the 50 most frequently dispensed brand prescription drugs, the 50 costliest prescription drugs by total annual spending, the 50 prescription drugs with the greatest increase of plan expense over the last year and prescription rebates/fees paid by manufacturers to the plan or carrier.

The RxDC is filed electronically on the Centers for Medicare and Medicaid Services (CMS) website which will collect the data for the Department of Health and Human Services, Department of Labor, Department of Treasury, and the Office of Personnel Management. CMS will publish an annual report summarizing the data it receives.  While this is the third required filing, prior filings allowed for extensions and good faith filing standards while the 2023 filing due June 1, 2024, allows no such extensions or good faith filing.

If you have questions, reach out to the author or contact your plan’s third party administrator to ensure you do not miss this deadline.

Sherry P. Porter

Sherry Porter has more than twenty years of experience in the employee benefits field.  She began her legal career as an investigator for the U.S. Department of Labor Employee Benefits Security Administration, where she conducted investigations to ensure compliance with ERISA and related laws and negotiated compliance agreements to correct violations.  Ms. Porter regularly advises clients on legislation affecting employee benefit plans, such as HIPAA privacy and security rules and the Patient Protection and... Read More