CAA Prescription Drug Reporting: What You Need to Know


What is prescription-drug reporting, and how does it affect you and your groups? Get the answers to these questions, and more, in this resource page.


What is Rx reporting?

Prescription-drug reporting is a federal mandate created by the Consolidated Appropriations Act of 2021, which was signed into law in December 2020. It requires insurance companies and group health plans to report prescription drug data to the government.


Why is the government doing this?

For years, prescription costs for drugs has been a hot topic. The federal government wants to use the data that will be reported to study the prescription drug industry; consider legislative or regulatory changes; and look at market concentration (i.e., essentially antitrust issues).


How does this affect agents and groups?

Insurance companies have sent a lot of questions and communications to groups about drug reporting. Some groups may not understand why this is happening. That’s where you come in: You can help guide your groups and facilitate the reporting process so they can meet their deadline.


Important things to note

Whether your group is fully insured or self-funded, they have work to comply with this mandate.


Groups must meet the following deadlines:

Calendar Years to ReportDeadline
2020 and 2021December 27, 2022
2022June 1, 2023
Each subsequent calendar yearJune 1 of each year

 

Resources

Here are some important resources you can reference, including links to detailed break-downs:


Carrier Responses

This section includes information from carriers on what they're doing about prescription drug reporting. It will be updated continually. 


CarrierAnnouncement
AetnaPharmacy benefit and drug costs reporting
Anthem Blue Cross (CA)California communication
Blue Shield of California (CA)Blue Shield compliance plan
CignaImportant information
Kaiser PermanenteImportant information
UnitedHealthcarePrescription drug and data reporting portal


Questions?

Call your Warner Pacific Sales Executive at (800) 801-2300.