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Health Plan Options |
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This email is intended for producers with business in Delaware, Pennsylvania, and West Virginia. INFORMATION RE: CAA Rx DC REPORTING WITH INSTRUCTIONAL VIDEO Knowing that the CMS mandated CAA RxDC reporting is due at the end of this month, we are providing the link for a Brainshark recording that was put together for our producer partners and clients. As you may be aware, Highmark will be handling the submission in the following format:
- Fully Insured Clients: Highmark will submit the complete filing
- Self-Funded Clients with Pharmacy Integrated: Highmark will submit P2 and Files D2-D8; Client or designated representative must submit D1 (Premium Equivalents and Life Years file) and accompanying P2 file
- Self-Funded Clients with Pharmacy Carved-Out: Highmark will submit P2 and D2 file; Client or designated representative/PBM must submit D1 and D3-D8 and accompanying P2 file.
With that being said and this being a new requirement this year, Nick Miller took the liberty of recording his screen as he went through the registration process himself for HIOS on the CMS portal, a walkthrough of what to expect for the D1 and P2 submission, and a review of Highmark’s Self-Funded Submission Guide FAQ. You’ll also find through the link several additional sites and attachments of various resources to help guide you through the process and any questions that come up from your teams or clients. Hopefully you and your agency find this helpful as we all navigate this requirement together.
https://www.brainshark.com/hmk/vu?pi=zHSz7kS8OzdGrlz0
Questions Feel free to reach out to the Producer Strategy team or the Client Manager assigned to your client with any questions or concerns! |
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