2023 RxDC Reporting Requirements and Guidelines

This guide outlines the 2023 RxDC reporting requirements that employers must adhere to in order to submit group health plan and prescription drug data to the Centers for Medicare and Medicaid Services (CMS) by June 1, 2024. It details the types of plans that are subject to these reporting requirements, including insured, self-insured, and level-funded plans, as well as the specific data that must be reported. Employers are responsible for determining which of their plans require reporting and must complete a questionnaire or survey from their medical carrier, third-party administrator (TPA), or pharmacy benefits manager (PBM). The guide also explains the reporting process, including the use of the Health Insurance and Oversight System (HIOS) portal for submissions, and emphasizes the importance of timely registration and data collection. Additionally, it provides instructions on calculating premium amounts for the D1 report and highlights the steps employers should take to ensure compliance with the reporting obligations.