Prescription Drug Data Collection (RxDC)

Under Section 204 of the Consolidated Appropriations Act (CAA) of 2021, health insurers offering group or individual health coverage and self-funded (ASO) group health plans are required to report data annually on prescription drugs and healthcare spending to the Departments of Health and Human Services (HHS), Labor (DOL) and Treasury (USDT).

The reporting is commonly referred to as “RxDC” where “Rx” stands for Prescription Drug and “DC” stands for Data Collection. It is important to note that the RxDC reports also require data unrelated to prescription drugs, including premium, enrollment, and other spending related to medical costs.

For more information about RxDC reporting, what the law requires, or how the federal government plans to use the data, you can visit the CMS website at https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/prescription-drug-data-collection.

Information for Current CareFirst Clients

Current clients can access and complete the web-based form for the Annual RxDC Information Submission by logging into the CareFirst Employer Portal.

• Resources for Small and Midsize Employer Groups (2-199 Employees)
  • RxDC Informational Guide for Fully Insured Group Health Plans
  • Small and Mid-market Employer Portal - RxDC Form Submission User Manual
• Resources for Large Employer Groups (Fully Insured)
  • RxDC Informational Guide for Fully Insured Group Health Plans
  • RxDC Form Submission User Manual - Fully Insured Large Group
• Resources for Self-Insured Clients
  • RxDC Informational Guide for Self-Insured Group Health Plans
  • Employer Portal RxDC Form Submission User Manual - Self Insured Employers
• Additional Resources
  • RxDC Form Submission User Manual – CareFirst Broker Portal

Note: Clients contracted with CareFirst Administrators (CFA) or National Claims Admin Services (NCAS) will receive a separate communication to submit their data.

Information for Former CareFirst Clients:

Former clients can submit the required information to CareFirst by clicking on the link to complete the appropriate survey below.

• Survey Links
  • Self-Insured Clients
  • Fully Insured Small Group Health Plans (2-50)
  • Fully Insured Mid/Large group Health Plans (51+)
• Instructional Guides
  • CareFirst RxDC Survey Guide – Fully Insured
  • CareFirst RxDC Survey Guide – Self-Insured

CareFirst will submit all RxDC files on behalf of our fully insured clients and our self-insured clients that are not contracted under a Shared Processing Services Agreement or Network Lease Agreement. CareFirst will submit data for all applicable clients.