Section 204 of the Consolidated Appropriations Act, 2021 requires insurance companies and employer-based health plans to report on their prescription drug and health care spending. This is known as the RxDC report where Rx represents prescription drugs and DC refers to data collection.
Reporting for the calendar year 2022 is due on June 1, 2023.
Insurance companies and employer-based health plans are required to provide information regarding:
- Prescription drug and health care service spending
- Prescription drugs that represent the most spending
- Prescription drugs that are prescribed most often
- Premiums and cost-sharing paid by patients
- Rebates from drug manufacturers
The Centers for Medicare and Medicaid Services is collecting this information for multiple government entities including the Department of Health and Human Services, Department of Labor, Department of Treasury, and Office of Personnel Management.
Collection and analysis of this data will assist with:
- Identifying key drivers of increases in both prescription drug and health care spending
- Understanding how prescription drug rebates impact premiums and out-of-pocket costs
- Increasing transparency in prescription drug pricing
In most cases, employers with fully-insured plans will be able to rely on their carriers for compliance. For self-insured plans, employers are typically liable for compliance and therefore should work with their vendors to ensure obligations are being met accordingly.
Ultimately, it is vitally important for employers to understand specifically what actions will be taken by their vendors/carriers and what they will need to handle themselves. For example, CareFirst is changing its involvement in the upcoming submission process, so clients will now be responsible for filing certain information such as the D1 Premium and Life Years report.
How BlueStone Services’ HR Outsourcing Team Can Help
We strive to help our clients improve their processes and free up their time so they can focus on what they do best. For items like this, BlueStone clients can connect with an HR expert on an as-needed basis to discuss the impact of employment law policy changes and advise on employee relations issues. Our hourly rate packages make it simple for you to select the right amount of time needed for your objectives. Need more support beyond compliance implementation advice? Work with us to take care of ongoing, day-to-day human resources operations. To learn more about how we can tackle your HR compliance and tasks, contact us.