Understanding the RxDC Report
Under Section 204 of the Consolidated Appropriations Act, insurance companies and employer-based health plans must submit information regarding prescription drug benefits and health care spending to the Centers for Medicare & Medicaid Services (CMS) by June 1 of each year for the prior year’s coverage. This report is also known as the RxDC Report.
In 2024, insurance companies and employer groups are required to report data on the average monthly premium paid by them and their employees who were enrolled in benefits in 2023. This information is reported on the D1 Template of the RxDC Report filing.
RxDC Employer Reporting Intake Form
The purpose of this intake form is to gather the required information to enable Sharp Health Plan to complete the D1 Template on your behalf. Please provide the information requested below for the 2023 calendar year and submit it by April 19, 2024.
If we do not receive the completed form by April 19, 2024, then you will be responsible for submitting all required data directly to CMS by June 1, 2024. Failure to do so could result in penalties.
Note: Prior to the 2023 reference year, average premium was calculated on a per-member-per-month basis. Starting with the 2023 reference year, the monthly average is not on a per-member basis. This means you should divide annual premium amounts by 12 instead of dividing by member-months when calculating the average monthly premium. For more information, please see the instructions linked below to complete items 7-8.