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Update: Requests to collect required CAA D1 prescription drug data begin this month

Large Group, Small Group, National | CO, CT, IN, KY, ME, MO, NH, NV, OH, VA, WI, CA, GA, NY-DOWNSTATE, NY-UPSTATE

Update: We are connecting with many employers that terminated their coverage with us in 2023 to support them with required prescription drug data reporting.

 

The Prescription Drug Data Collection (RxDC) reporting provision of the Consolidated Appropriations Act (CAA) requires reports on drug utilization and spending trends be submitted to the U.S. Department of Health and Human Services each year. Starting last year, we are required to include the average monthly premiums paid by members and by employers in the Premium and Life Years (D1) reporting.

The next RxDC report is due by June 1, 2024. To meet the requirement, we will follow the same process as last year and file on behalf of our fully insured and ASO clients for the benefits we administer and maintain. This includes ASO groups who opt-in to the D1 reporting. In order to submit all required information and ensure reporting accuracy, we will request some information from our clients.

Here is a summary of the communications we will send to Large Group, Small Group, and National Account clients and the actions they will need to take for us to complete their required RxDC filing.

Fully Insured clients

  • The week of February 12 – We will email Fully Insured National Account, Large Group, and Small Group commercial clients, as well as clients with Minimum Premium, MEWA, and Anthem Balanced Funding plans. The email will include a link to an online form for these clients to provide the information we need to complete the filings on their behalf.
  • The week of February 26 - We are emailing Fully Insured National Account, Large Group, and Small Group commercial clients that terminated their coverage with us in 2023 and providing a link to an online form they can use to send us the required information.

ASO client D1 opt-in

  • The week of February 12 –We will email ASO Large Group and National Account clients and provide a link for them to request that we file their 2023 D1 Premium and Life Years report. For those who opt-in, we will submit the aggregated data by market segment on their behalf for the benefits we administer and maintain.
  • The week of February 26 – At their discretion, our account team may contact ASO Large Group and National Account clients that terminated their coverage with us in 2023 and offer to file their 2023 D1 Premium and Life Years report on their behalf.

The week of June 3, 2024 -- Confirmation of RxDC filing

  • We will email all Fully Insured and ASO commercial groups, including National Accounts, Large Group, and Small Group clients, to notify them that we have completed the required 2023 filing of prescription drug data on their behalf in compliance with the federal regulations. This information will also be published to EmployerAccess Latest News.

For more information about the Consolidated Appropriations Act RxDC reporting requirements, please visit our CAA/Transparency Resource Center, CMS’ RxDC information page, or contact your Anthem representative.