Pharmacy Benefits and Drug Costs Reporting [CAA, Transparency Provision]
Pharmacy Benefits and Drug Costs Reporting [CAA, Transparency Provision]
Pharmacy Benefits and Drug Costs Reporting [CAA, Transparency Provision]
Section 204 (division BB) requires health plans to report information on medical costs and prescription drug spending for the previous plan year to the Department of Health and Human Services (HHS), the Department of Labor, and the Department of Treasury.
Market impact of this provision effects Individual Family Plan (IFP), Small Business Markets (SBM), Core, Premier, Administrative Services Only (ASO) and Shared Advantage (SA) lines of business.
In preparation for the reports due June 1, 2023, Blue Shield is collecting and report D1 Premium and Life Year data on behalf of our groups and group plan sponsors according to the reporting responsibilities here.
Groups will need to fill out this intake form before March 31, 2023. Group plans who miss this deadline will not be included in Blue Shield's filing and may be subject to non-compliance if they do not then report the required data directly to the CMS on their own.