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Prescription Drug Data Collection Update

Employee Benefits

On December 23, 2022, the Departments of Labor, Health and Human Services, and the Treasury (Departments) released updated guidance on Prescription Drug Data Collection as required by the Consolidated Appropriations Act, 2021. The updated guidance creates a submission grace period which allows the required data for 2020 and 2021 to be submitted until January 31, 2023.

Updated Guidance Included the Following Clarifications

  • Good Faith Relief: As part of the updated guidance, the Departments announced they would not take enforcement action against any plan sponsor or issuer that uses a good faith, reasonable interpretation of the regulations and the Prescription Drug Data Collection Reporting Instructions to make their submission.
  • Submission Grace Period: In addition to the good faith relief, the Departments announced that any plan or issuer who makes a good faith submission of the required 2020 and 2021 data by January 31, 2023 will not be considered out of compliance. This extends the deadline to submit the required data by a little over a month as, under the prior guidance, the submissions were due by December 27, 2022.

Plan Sponsor Requirements

Fully insured plan sponsors and self-funded plan sponsors whose third party administrator (TPA) and/or pharmacy benefit manager (PBM) are submitting the required data on their behalf should have little to do as they are not submitting the required data themselves. Additionally, self-funded plan sponsors that have already submitted the required data will not need to take action.

The updated guidance is important for self-funded plan sponsors who are required to submit data but have not yet done so. Fortunately there is still time to submit the required data. Good faith submissions made by January 31, 2023 will be considered compliant.

Key Takeaway:

The updated guidance extends the deadline to submit the required Prescription Drug Data Collection information until January 31, 2023. Self-funded plan sponsors should make sure they submit required data by January 31, 2023 to remain compliant.

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