Four federal agencies are starting to set up what could be a large, complicated prescription plan cost reporting program.

On Monday, the agencies put out a request for ideas on how to implement the Consolidated Appropriations Act of 2021 (CAA 2021) drug cost transparency provision, which requires each health insurance issuer or self-funded employer health plan to send the government an annual report providing:

• General size and location information for each plan or coverage the payer offers.
• A list of the payer's 50 most frequently dispensed brand-name prescription drugs.
• The total number of paid claims for each of those 50 drugs.
• The 50 most costly prescription drugs by total annual spending.
• The amount the payer expects to spend each year on the 50 most costly drugs.
• The 50 drugs with the great increase in plan spending, when compared with spending for the previous year.

The agencies involved are the U.S. Department of Labor's Employee Benefits Security Administration (EBSA); the U.S. Personnel Management Office (OPM); the U.S. Department of Health and Human Services (HHS); and the Internal Revenue Service.