Industry Outreach
Telecommunication Standard Version D.0 Web casts
Reciprocal Agreements with Other Organizations
NCPDP Emergency Preparedness
Medication Therapy Management Services White Paper
Industry SIG Task Group
MMA Eprescribing Pilot Guidance
Telecommunication Standard Version D.0 Web casts
Telecommunication Standard Version D.Ø: Prior Authorization and EligibilityThe webcast will help attendees gain an understanding of the changes associated with the prior authorization transactions since Telecommunication Standard Version 5.1 and attendees will be provided with clarifications that explain the prior authorization process. The program will also provide an overview of the enhanced Eligibility Transaction between the pharmacy and the Facilitator. The presentation will cover all new fields that have been added to the Eligibility transaction as well as what is needed for software vendors and retail pharmacy providers to successfully implement the Version D.Ø enhanced Eligibility Transaction for Medicare Part D claims.
Click here to purchase an archived version of this webcast.
Telecommunication Standard Version D.Ø: Coordination of Benefits (COB) and Pricing
The webcast will explore how proposed changes to the pricing capabilities of the NCPDP Telecommunication Standard impact the operational and systems capabilities of your business. The program provides an overview of the revised pricing formulas, identification of new pricing fields and values, and examples of how these fields are used. The program provides an overview of the three COB methods available, revised/new fields, examples of how these fields are used and information about COB processing. The presentation will focus on what is needed for retail pharmacy providers, pharmacy benefit administrators and system vendors to successfully implement the Version D.Ø COB enhancements.
Click here to purchase an archived version of this webcast.
Telecommunication Standard Version D.Ø: Compounds and Medicare Part B
The webcast will describe the submission and processing of the NCPDP multi-ingredient compound claim transaction including a claim request and response. The web cast will explore how Medicare Part B changes to the NCPDP Telecommunication Standard impact the operational and systems capabilities of your business. The program provides an overview of the new fields and segments supporting a Medicare Part B claim and response, discusses the differences between submitting a Medicare Part B claim using the Version 5.1 Telecommunication Standard and the Version D.Ø Telecommunication Standard. Examples include: Medicare Part B single claim, Medicare Part B COB, Payer-to-Payer communications, and a Medicare Part B claim example with the submission of a Certificate of Medical Necessity (CMN).
Click here to purchase an archived version of this webcast.
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Reciprocal Agreements with Other Organizations
NCPDP has signed Memorandums of Understanding (MOUs) or reciprocal agreements with industry organizations to share in industry participation. General terms of the reciprocalsInter SDO Process
ASC X12
HL7
WEDI
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NCPDP Emergency Preparedness Information document
During the Katrina and Rita hurricanes, the pharmacy industry (as well as other participants) came together to offer products, services, and care to displaced individuals. During the 2ØØ6 NCPDP Annual Conference, an Educational Session was held of “A Panel Discussion on Disaster Preparedness: Lessons Learned from Mother Nature᾿. While there were many areas that needed improvement in reacting to a disaster based on this panel’s experience, and there are many aspects to a disaster, it was suggested that there were some actions the NCPDP community could provide for future disasters. The NCPDP Emergency Preparedness Committee was formed by the NCPDP Board of Trustees. The Committee began meeting and determining what aspects of preparation for a disaster would be within its purview. A document has been prepared by the Committee to assist in information sharing and processing. NCPDP is a standards development organization, which brings together many participants in the pharmacy services sector, to help find solutions to business problems. There are sections on the CMS emergency payer and the pharma section that need to be completed. There are discussions going on with CMS, but as to when an emergency payer might actually exist, we do not know. If there are items for pharma that can be added at some point, we will do so. The NCPDP Emergency Preparedness Committee is currently working on a usage drill of the document to take place in the summer of 2007.[Top]
Medication Therapy Management Services White Paper
WG10 Professional Pharmacy Services has created a medication therapy management services white paper. This document recommends that the NCPDP Telecommunication Standard v5.1 be officially recognized for use in submitting medication therapy management service claims. Click here for a copy of this document.[Top]
Industry SIG Task Group
This is an industry initiative, driven in part by the Medicare Modernization Act requesting the National Committee on Vital and Health Statistics (NCVHS) to offer recommendations specifically on aspects of patient care and electronic prescribing. There are some aggressive timelines - CMS requested that standard SIG be in use for the January 2006 MMA (Medicare Modernization Act) demonstration pilot. To make this date, a draft standard for SIG would need to be available for vendors by mid-2005. It is recognized that the standard for SIG may be the guidance and rules and not a standard. It is also recognized that the guidance in and of itself not be what is implemented, but rather be used inside message standards (NCPDP SCRIPT, HL7, CCR, etc). It is further recognized that given the timeframes, any standard may not be through the full ballot and ANSI-accreditation process; however these are steps the standards would be taken through. For the demonstration pilots, vendors would be implementing the draft. For more information, contact Lynne Gilbertson lgilbertson@ncpdp.org. Please also see the MMA Eprescribing Pilot Guidance below for important information for piloters.06/2006 Updated Version 1.0 Structured and Codified Sig Format - Draft Guidance for CMS/AHRQ Eprescribing Pilot
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MMA Eprescribing Pilot Guidance
The Agency for Healthcare Research and Quality (AHRQ), on behalf of the Centers for Medicare & Medicaid Services (CMS), is conducting pilots of electronic prescribing standards under cooperative agreements that will inform the implementation of the Medicare Prescription Drug Benefit. NCPDP Task Groups are assisting the pilots by providing guidance on areas of the pilots for which standards have not yet been completed, or functionality has not been tested.This document (Updated 12/2006) provides a consistent use of data elements, code sets, functionality, etc not currently in NCPDP published documents to the participants in the AHRQ/CMS Eprescribing Pilots. Some of the requirements of the pilot require functionalities of the use of RxNorm in eprescribing, the use of a structured Sig (instructions), and prior authorization utilization. New work is underway on SNOMED cross-reference mapping to Federal Medication Terminology to determine synergy/gaps, based on HITSP recommendations.
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