America's Benefit Specialist August/September 2023

RxDC REPORTING: BEST PRACTICES FOR STRESS-FREE REPORTING IN 2024

By Ben Smith, JD Managing Director, ACAPrime

Indianapolis, Indiana ben@acaprime.com

1. Understand the requirements . Generally, all employers that offer a group health plan, regardless of size, are sub ject to RxDC reporting and ultimately responsible for its completion. The intricacies of regulatory compliance can be complex, and plan sponsors may not be well-versed in the specific reporting requirements for RxDC. Your clients can familiarize themselves with the specific requirements and guidelines provided by CMS and the HIOS system for reporting. This includes understanding the necessary data elements, formats, submission deadlines and any support ing documentation that may be required. CMS provides great resources on its RxDC website: www.cms.gov/CCIIO/ Programs-and-Initiatives/Other-Insurance-Protections/ Prescription-Drug-Data-Collection. 2. Establish clear responsibility/ownership of tasks in advance. So many times, we talked with employers that thought they needed to complete all the reporting them selves, or they thought someone else had completed all the reporting for them, when, in reality and regardless of

Over the past couple of months, many employers that are plan sponsors of group health plans were caught by surprise that they had a responsibility to create and submit RxDC reports to CMS via the Health Insurance Oversight System. Completing the RxDC (Prescription Drug Data Collection) reporting to CMS via HIOS can be a complex process. There are several lessons learned that can help ensure a smoother experience for reference year 2023 reporting. Here are five key takeaways: RxDC REPORTING IS NOT GOING AWAY! KEEP ABREAST OF ANY UPDATES, CHANGES, OR CLARIFICATIONS FROM CMS OR THE HIOS SYSTEM REGARDING REPORTING REQUIREMENTS.

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