Filing & ReportingAnnual

Prescription Drug Data Collection (RxDC) Reporting

CAA 2021 § 204; ERISA § 725; PHS Act § 2799A-10

Plans and issuers must report prescription drug and health care spending data to CMS. Includes top 50 brand drugs by spend, top 50 most utilized generics, Rx rebate data, premium and cost-sharing trends, and total spending by category. For fully insured plans, the carrier typically reports the bundled data to HIOS; the plan sponsor may need to provide its share of premium data to the carrier for inclusion.

ResponsibleMedical Carrier/TPA

Deliver ToCMS (via Health Insurance Oversight System – HIOS)

DeadlineAnnually by June 1 (covering prior calendar year); previously semi-annual, now annual per final rule

Current Fee / Rate Information

No filing fee. Annual submission to CMS by June 1. Covers prior calendar year. Plans, issuers, and PBMs may coordinate reporting responsibilities.

Last reviewed: April 2026

Non-Compliance Penalties

Failure to report: $100/day per affected individual under ERISA § 502(c)(10). CMS enforcement is evolving.

Official Source

https://www.cms.gov/marketplace/about/oversight/other-insurance-protections/prescription-drug-and-health-care-spending

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