CMSRxDC Form

Please complete this mandatory questionnaire no later than February 13, 2026. 

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 2025 is due on June 1, 2026.

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 2025. 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:

2025 CMS RxDC Reporting Questionnaire

* Asterisk indicates required field