NCPDP has released a new version of the Manufacturer Rebate Utilization, Plan, Formulary, Market Basket, and Reconciliation Flat File Standard Implementation Guide Version 07 Release 02.
The Manufacturer Rebate Standard provides a standardized format for the electronic submission of files intended to be used in an integrated manner, with the utilization file being supported by the plan, formulary, market basket, and reconciliation files. Enhancements available in version 07.02 include but are not limited to:
- Diagnosis code information;
- Additional fields for formulary and benefit file cross reference to eliminate use of the formulary field to reference these additional files;
- Utilization management indicators if formulary and benefit coverage files are not available or not a viable option;
- 340B discount indicator;
- Additional patient liability fields to provide detailed information on deductibles, tax, and copay/coinsurance; and
- Modifications to values/definitions associated with Reconciliation Status Code, Reconciliation Reason Code, Reconciliation Error Description.
The enhanced Manufacturer Rebate Standard is now available to members in the Member Portal