Have you heard about the new prescription drug reporting requirement?

If you haven’t heard of the newly required RxDC Report, now is the time to get up to speed. The Consolidated Appropriations Act, 2021 includes the No Surprises Act (NSA), which mandates that group health plans and health insurance issuers must report information on prescription drugs and health care spending to the Departments of Labor, Health and Human Services, and Treasury. This prescription drug data collection (RxDC report) requirement applies to group health plans and health insurance issuers in the individual and group markets, but not to account-based plans and excepted benefits. The first RxDC report was due by December 27, 2022, but the Departments provided a submission grace period through January 31, 2023, for the first report. The second RxDC report is due by June 1, 2023, covering data for 2022.

The NSA requires group health plans and health insurance issuers offering coverage in the group and individual markets to report specific information on plan medical costs and prescription drug spending to the Departments. Plans must report: (1) general information on the plan or coverage, (2) the 50 brand prescription drugs most frequently dispensed by pharmacies, (3) the 50 most costly prescription drugs, (4) the 50 prescription drugs with the greatest increase in plan expenditures over the prior plan year, (5) total spending on health care services by the group health plan, (6) the average monthly premium paid by employers and enrollees, (7) and any impact on premiums by rebates, fees, and other remuneration paid by drug manufacturers to the plan. Additionally, plans must report any reduction in premiums and out-of-pocket costs associated with rebates, fees, or other remuneration.

Although this report requirement may be confusing at first, it aims to be beneficial in the long run. The reported data will help the Departments identify major drivers of prescription drug and health care spending, understand how drug rebates impact premiums and out-of-pocket costs, and promote transparency in prescription drug pricing. 

Although the first report deadline has passed, the second report deadline is quickly approaching, and compliance with the reporting requirements is essential to avoid potential enforcement action.

To learn more about the RxDC report, reach out to an agent at Diversified or visit: https://www.thehortongroup.com/resources/prescription-drug-data-collection-rxdc-reporting/.

DII is your partner in workplace compliance and understanding business requirements. Our team of experts can work with you to understand how to update your policies and make sure you meet all reporting deadlines. Please contact your DII representative for more information. #RxDC #Reporting #NSA #PrescriptionDrugs