Annual RxDC Reporting
Sentara Health Plans is in the process of collecting the data required to submit RxDC reports on behalf of fully insured and self-funded large groups for calendar year 2025. We are sending all large groups an email with information on how to submit the required data.
Please ensure that fully insured and self-funded groups use their designated link below to complete the form no later than February 27, 2026.
If they do not complete the form or alert a Sentara Health Plans representative that they do not wish for us to submit on their behalf by the deadline they will be responsible for submitting their group’s information directly to CMS.
We will submit all medical data and have delegated Express Scripts (ESI), our pharmacy benefits manager, to submit all pharmacy related data. ESI will only submit on behalf of groups that have pharmacy benefits with Sentara Health Plans. If their group carves out benefits, they will need to report their own pharmacy data or contact their pharmacy benefits manager.
Sentara Health Plans is in the process of gathering the required data to meet the RxDC reporting timelines under the Consolidated Appropriations Act (CAA).