The Consolidated Appropriations Act (CAA) requires group and individual health plans to report annual data about prescription drugs and health care spending to the Centers for Medicare & Medicaid Services (CMS). The last day to submit this data to CMS for the 2025 reference year is June 1, 2026.
- If Excellus BlueCross BlueShield (BCBS) Manages Both Medical And Pharmacy Group Benefits
- If Excellus BCBS DOES NOT Manage Pharmacy Group Benefits
If Excellus BCBS Manages Both Medical And Pharmacy Group Benefits
We will complete the required pharmacy benefit and prescription drug cost reporting for fully insured and self-funded groups with Excellus BCBS medical and pharmacy coverage. However, you or your clients must use the online Prescription Data Collection (RxDC) form to submit premium contribution information for the 2025 reference year to Excellus BCBS by April 10, 2026.
Complete The Prescription Data Collection (RxDC) Form
If the form does not load, firewall or security settings may be blocking it. Please review your firewall settings or contact your IT department if you are on a work or school network.
Self-funded groups who wish to request their data to complete their own reporting and opt-out of our standard process should reach out to their account manager by April 10, 2026. Additional fees will apply.
If you have questions on the form or 2025 RxDC reporting process, please reach out to your Account Manager.
If Excellus BCBS DOES NOT Manage Pharmacy Group Benefits
We will include the group’s data in our aggregate book of business reporting and submit on their behalf the following reports only:
- P2 – Group Health Plan List
- D2 – Spending by Category (Medical Claims data only)
- Narrative Responses – Employer size for self-funded plans and medical benefit drugs
The group will receive a D1 file via Information Connection the week of May 11, 2026, containing medical claims, admin fees, and enrollment data. The group and/or issuer of the Rx plan must submit the D3 - D8 files directly to CMS.
If you have questions on the 2025 RxDC reporting process, please reach out to your Account Manager.
