Excellus BCBS Broker News Vol. 20 No. 3 Special Issue Copy

It’s Time To Report Your 2024 Prescription Data

The Consolidated Appropriations Act (CAA) requires group and individual health plans to report annual data about prescription drugs and health care spending to the Center for Medicare & Medicaid Services (CMS). The last day to submit this data to CMS for the 2024 reference year is June 1, 2025.

Excellus BlueCross BlueShield will complete the required pharmacy benefit and prescription drug cost reporting for fully insured groups and self-funded groups. However, you must submit premium contribution information for the 2024 reference year to Excellus BCBS by April 11, 2025.

Self-funded groups: For self-funded groups who have pharmacy coverage with Excellus BCBS, Excellus BCBS must report the premium equivalent amounts representing the total cost of providing and maintaining coverage, including claims costs, administrative costs, Administrative Services Only (ASO) and other third-party administrator fees, and stop-loss premiums. Use the online form to submit this data by April 11.

• Self-funded groups who have pharmacy coverage with an external vendor will need to complete certain data files and submit directly to CMS.
• Self-funded groups who wish to request their data to complete their own reporting and opt-out of the standard process should reach out to their account manager by April 11. Additional fees will apply.

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Submit Your Data Using Our Online RxDC Form

If Excellus BCBS is completing report D1 on your behalf, they need to know any costs paid directly by your group to parties other than Excellus BCBS or Lifetime Benefit Solutions for providing and maintaining coverage in 2024.

To help collect this data, they have created an online Prescription Data Collection (RxDC) form, available now.

Please complete this online form as soon as possible. If the form does not load, your firewall settings may be blocking it. Please check your firewall or security software to see if it's restricting certain websites. If you are on a work or school network, contact your IT department for assistance.

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