2023 UnitedHealthcare approach to CAA Prescription Drug Data Collection (RxDC) Reporting
Beginning mid-2023: UnitedHealthcare to submit required CAA files for applicable groups.
Under the Consolidated Appropriations Act (CAA), health insurers offering group or individual health coverage and self-funded group health plans are required to report data annually regarding prescription drugs and health care spending to the Departments of Health and Human Services, Labor and Treasury (Tri-Agencies). June 1, 2023, is the required submission date to report 2022 data through a web portal set up by the Centers for Medicare & Medicaid Services (CMS).
UnitedHealthcare approach and support
Beginning with the June 1 submission date, UnitedHealthcare will be submitting the P2 (Group Health Plan), D1 (Premium and Life Years) and D2 (Spending by Category) files for all fully insured and self-funded customers who had active coverage during the reference year 2022.
- UnitedHealthcare will also submit the D3-D8 files for customers with OptumRx integrated PBM.
- Customers who use any other PBM, including OptumRx Direct, must follow the Pharmacy Benefits and Costs ASO Reporting Guide and work with that PBM to submit the D3-D8 files.
- UnitedHealthcare will collect P2/D1 data annually from each customer to complete the Rx Data Collection Reporting. Select customers will receive a survey to submit data not currently in UnitedHealthcare systems.
- Before completing the survey, customers may wish to gather data that may be needed including:
- Member and employer average premium
- Self-funded administration fee/TPA fee (if applicable)
- Medical, pharmacy, behavioral, wellness, stop loss vendors and their Employee Identification Number (EIN) if a customer has coverage from vendors other than UnitedHealthcare
- The required information must be entered using the following survey link.
- UnitedHealthcare customers must complete the survey by the March 3 deadline.
Important: Customers must complete the survey no later than March 3, 2023. This deadline is firm. If the survey response is not completed and received by March 3, UnitedHealthcare will submit the limited P2/D1 data in our system on or before the June 1 due date. However, the submission will not be complete. Data elements not provided to UnitedHealthcare will need to be submitted to CMS by the health plan or another reporting entity. The health plan accepts any risk arising from the health plan’s failure to provide any requested information to UnitedHealthcare for reporting.
Self-funded customers wishing to have UnitedHealthcare provide data to them and who will take responsibility to submit all data to CMS themselves, must contact their UnitedHealthcare representative no later than March 3, 2023.
For questions, please contact your UnitedHealthcare representative.