The 2021 Consolidated Appropriations Act (CAA) requires group and individual health plans to report annual data about prescription drugs and health care spending to the Center for Medicare & Medicaid Services (CMS). The last day to submit this data to CMS for the 2023 reference year is June 1, 2024.
Univera Healthcare will complete the required pharmacy benefit and prescription drug cost reporting for fully insured groups and self-funded groups. However, you must submit premium contribution information for the 2023 reference year to Univera Healthcare by April 12, 2024.
Self-funded groups: For self-funded groups who have pharmacy coverage with Univera Healthcare, we must report the premium equivalent amounts representing the total cost of providing and maintaining coverage, including claims costs, administrative costs, Administrative Services Only (ASO) and other third-party administrator fees, and stop-loss premiums. Use the online form below to submit this data by April 12.
Self-funded groups who have pharmacy coverage with an external vendor will need to complete certain data files and submit directly to CMS.
Submit Your Data Using Our Online RxDC Form
If we are completing report D1 on your behalf, we need to know any costs paid directly by your group to parties other than Univera Healthcare or Lifetime Benefit Solutions for providing and maintaining coverage in 2023.
To help collect this data, we created an online Prescription Data Collection (RxDC) form.
Please complete this form as soon as possible. If a group does not complete the online web form, the filing will still be completed by us on their behalf using an average based on responders.
If you have a question about the form or process, please contact your account manager.
Prescription Data Collection (RxDC) Form
