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Group health plans and insurers must submit annual prescription drug and healthcare spending data to Centers for Medicare & Medicaid Services (CMS). This reporting is referred to as the “prescription drug data collection” or RxDC report.
The next RxDC report, covering 2024, is due by June 1, 2025. The report includes files with plan-level details like plan dates, enrollment, premium data, and specifics on medical and pharmacy benefits.
Many employers rely on third parties like issuers, third-party administrators (TPAs), and pharmacy benefit managers (PBMs) to submit RxDC reports for their health plans. They may collaborate with multiple third parties to ensure all parts of the report are completed. A submission is complete once CMS receives all necessary files, regardless of who submits them.
Action Steps
Employers should contact their issuers, TPAs, or PBMs to ensure RxDC file submission for health plans by June 1, 2025, and verify that reporting responsibilities are covered in their agreements.
Employers must provide plan-specific data for RxDC submissions and promptly respond to vendor surveys. Those with self-funded plans should ensure their TPAs or PBMs comply with RxDC reporting requirements. Download the bulletin for more details.
Reporting Resources
Reporting Instructions (updated January 2025, no changes from last year)
User Manual for submitting RxDC reports
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