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Rx Data Collection  & Reporting

Who is required to submit the RxDC Report?

  • Health insurance issuers offering group coverage

  • Health insurance issuers offering individual market coverage, including:

    • Student health plans

    • Plans sold through the Exchanges

    • Plans sold outside of the Exchanges

    • Individual coverage issued through an association
       

  • Fully-insured and self-funded group health plans, including:

    • Non-federal governmental plans, such as plans sponsored by state and local government

    • Church plans that are subject to the Internal Revenue Code

    • Federal Employees Health Benefits (FEHB) Plans

Who is NOT required to submit?

  • Account-based plans, such as health reimbursement arrangements

  • Excepted benefits including but not limited to:

    • Short-term limited-duration insurance

    • Hospital or other fixed indemnity insurance

    • Disease-specific insurance

  • Medicaid Plans

  • State children's health insurance program plans

  • Basic Health Program plans

These requirements apply regardless of whether a plan is considered a grandfathered or grandmothered health plan.

 

How will this information be used?

The data submitted by BABD Data Services will help to:

  • Identify major drivers of increases in prescription drug and health care spending

  • Understand how prescription drug rebates impact premiums and out-of-pocket costs

  • Promote transparency in prescription drug pricing

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