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2023 CMS RxDC (Prescription Drug Data Collection) Reporting Questionnaire

Please complete this mandatory questionnaire no later than March 15, 2024. 

The Prescription Drug Data Collection Reporting provision, (Section 204) of the Consolidated Appropriations Act of 2021, requires information about prescription drugs and health care spending. The next mandatory filing for plan year 2023 is due on June 1, 2024.

CMS requires some data that we do not store in our systems; therefore, we need to obtain that data from our customers. Specifically, data required includes the Premiums Paid by Members (employee contributions). The employer groups will need to submit this information to HAP so that we may file data on their behalf.

Total employee premium contributions should include all employees enrolled on the HAP Medical/Rx (fully insured or self-funded) plan during 2023. COBRA and Medicare Advantage should not be included. The calculation is based on the calendar year, even if your plan year is not a calendar year. 

PLEASE COMPLETE THE FOLLOWING:

2023 CMS RxDC Reporting Questionnaire

* Asterisk indicates required field

Enter 8-digit number, beginning with a “1000…” or “2000…”

If employees do not pay a premium, enter zero dollars

(you may need to obtain this data from your payroll service)

Please print your above responses before submitting, as a copy for your records. There is a print button at the top of this page.

If you have questions or need assistance, please contact your agent or HAP or HAA account representative.

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