How we’re supporting RxDC reporting for groups that terminate in 2024

August 27, 2024

The Consolidated Appropriations Act, 2021, requires health insurance issuers to report plan members’ prescription drug and health care spending data to the Centers for Medicare & Medicaid Services (CMS) each year. Called Prescription Drug Data Collection (RxDC), the reporting for each year is due to CMS on June 1 of the following year.

We have established a process to include in our reporting to CMS, as a courtesy, groups that terminate coverage with us in 2024. We will include only the RxDC information for months in 2024 when their coverage with Regence was active. Another entity will need to submit RxDC information to CMS for other months.

We’re mailing letters to notify groups (fully insured and self-funded ) that terminated their coverage about this option and explain information they’ll need to provide us in order to be included in our reporting. The first wave of these letters, being mailed by the end of this month, will go to groups that terminated coverage January through May; in November, we’ll mail a second wave of letters to groups that terminate coverage from June through September.

As a reminder, we include fully insured groups in our RxDC reporting because we hold all their benefits data in our systems except the total premium they collected from employees. Although we also offer to include self-funded groups in our RxDC reporting each year as a courtesy, it is each self-funded group’s obligation to ensure reporting is submitted to CMS on their behalf—either by us, another entity or themselves. In our reporting to CMS, we will include only self-funded groups that provide us the required information.

Questions? Please email RxDCQuestions@regence.com.