RxDC Reporting from ACAPrime

What is Federal RxDC Reporting?

Rx = Prescription Drugs          +         DC = Data Collection

Due Date:   June 1 Every Year

Required to Submit:  Sponsors of self-funded group health plans.

Penalty for Non- Compliance:

Employers that fail to report the required data may be subject to penalties under both ERISA and the IRS Code. Failure to furnish information relating to the benefit plan results in approximately $100 per day per violation.

Deliverables:

  • Narrative Response
  • D1 Premium and Life-Years
  • D2 Spending by Category
  • P2 Group Health Plan List         (Note:  P1 is for individual market)

Filing:

  • ACAPrime will provide you with a submission packet
  • Additional services available if your TPA/PBM is not providing D3-D8 and/or not submitting files on your behalf. Price to be determined.

ACAPrime: Systems and Data Experts meets Compliance Expertise

We simplify the process for you as much as possible.  Like our ACA reporting service, we have scoured

all of the rules and regulations to make sure everything is done on time and accurately. Furthermore, we make it as easy as possible to just give this compliance requirement to us and have us fulfill it.

 

  • Dedicated client manager works directly with plan sponsors to complete RxDC reporting
  • Assist with the collection of data, analysis and aggregation into required format to report
    • Data from the employer
    • Data from TPA, PBM, broker and/or carrier, as needed
  • Creation of the submission packet
    • Plan List file(s), Data files and the Narrative Response
  • Ensure final reporting is accurate and timely submitted
  • Filing options:
    • ACAPrime provides a submission packet for the plan sponsor to file
    • ACAPrime submits files on behalf of the plan sponsor (*additional $150 fee)
  • Ongoing support for questions and audits

More on RxDC Reporting:  Under Section 204 (of Title II, Division BB) of the Federal Consolidated Appropriations Act, 2021 (CAA), employer-based health plans must submit information about prescription drugs and health care spending. The RxDC report isn’t only about prescription drugs. It also collects information about spending on health care services and premiums paid by members and employers.

(From:  https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/prescription-drug-data-collection)

 

About ACAPrime

ACAPrime, part of ChannelBound, LLC was built by Enterprise Software Application Integrators and Compliance Experts.  We are able to easily handle complex data sets from multiple sources.  Our process incorporates both manual and automated quality auditing to ensure accurate reporting in an efficient manner.