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:

Resources

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

• News announcement
  • Government provides enforcement relief for Rx reporting
• Warner Pacific webinar with expert and attorney Marilyn Monahan
  • Consolidated Appropriations Act - Prescription Drug Reporting
• Marilyn Monahan Presentation: Quick Links
  • Entire PowerPoint presentation
  • What group health plans and issuers have to file
  • What data is reported?
  • Examples of data that’s reported
  • What data may employers have to furnish?
  • What aggregated data is reported?
  • Aggregation process
  • The filing process
  • Break down of action items for employers
• Departments of Labor, Health and Human Services, and the Treasury
  • Announcement of enforcement relief and FAQ
• Centers for Medicare & Medicaid Services
  • Prescription Drug Data Collection (RxDC)

Carrier Responses

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

Questions?

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