RESOURCES

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Documents | Guides and Templates

HIPAA Information 

HIPAA Information 

This section contains information for the public about the Health Insurance Portability and Accountability Act of 1996 as it relates to the pharmacy industry.

Documents

Task Group Listing

Task Group Listing

Comprehensive listing of NCPDP active Task Groups

Documents | Guides and Templates

SCRIPT Implementation Recommendations Document Version 1.63

SCRIPT Implementation Recommendations Document Version 1.63

This document provides requirements and best practice guidance for implementation when transmitting NCPDP SCRIPT transactions. This document also contains editorial corrections, clarifications to the NCPDP SCRIPT Implementation Guide documents.

Press Releases

NCPDP Announces Pilot Launch of its National Facilitator Model to Strengthen Pandemic and Epidemic Preparedness & Response and Support Public Health Surveillance
 

NCPDP Announces Pilot Launch of its National Facilitator Model to Strengthen Pandemic and Epidemic Preparedness & Response and Support Public Health Surveillance
 

NCPDP announced today the pilot launch of its National Facilitator Model which can be used to provide real-time information on prescription, testing, immunization, and related data to pharmacies, prescribers and government agencies to aid in pandemic and epidemic response, proactive intervention and public health surveillance.

Documents | Guides and Templates

X12N 835 Payment Guidance and Related Documents - Low Income Subsidy (LIS) Reporting Transaction

X12N 835 Payment Guidance and Related Documents - Low Income Subsidy (LIS) Reporting Transaction

WG45 External Standards Assessment, Harmonization and Implementation Guidance revision of the Low Income Subsidy (LIS) Reporting Transaction was completed August 2012 and last updated October 2022. This document provides guidance to the pharmacy sector of the health care industry for reporting the outcome of a payer initiated retro-active Low Income Subsidy (LIS) adjustment of pharmacy claims using the X12/005010X221 Health Care Claim Payment/Advice (835) to their long term care (LTC) business partners.

Documents | Guides and Templates

X12N 835 Payment Guidance and Related Documents - Central Pay Transaction

X12N 835 Payment Guidance and Related Documents - Central Pay Transaction

WG45 External Standards Assessment, Harmonization and Implementation Guidance revision of the Central Pay Transaction was completed October 2014 and last updated October 2022. This document provides guidance to the pharmacy sector of the health care industry to convey a consistent solution for recovering overpayments from a Central Pay Prescription Service Administration Organization (PSAO) and/or financial intermediary via the X12/005010X221A1 Health Care Claim Payment/Advice (835).

Documents | Guides and Templates

X12N 835 Payment Guidance and Related Documents - NCPDP Pharmacy Reference Guide to the X12/005010X221 Health Care Claim Payment/Advice (835)

X12N 835 Payment Guidance and Related Documents - NCPDP Pharmacy Reference Guide to the X12/005010X221 Health Care Claim Payment/Advice (835)

WG45 External Standards Assessment, Harmonization and Implementation Guidance revision of the NCPDP Pharmacy Reference Guide to the X12/005010X221 Health Care Claim Payment/Advice (835) was completed May 2010 and last updated in March 2017. The NCPDP Pharmacy Reference Guide to the X12/005010X221 Health Care Claim Payment/Advice (835) document must be used in conjunction with the X12/005010X221 and does not supersede it. The reference document is meant to supplement the provider manuals that payers build. Payers can use this document to convey the important features of supporting the X12/005010X221 to their business partners.

Documents | Guides and Templates

NCPDP Emergency Preparedness Guidance 

NCPDP Emergency Preparedness Guidance 

This document provides resource information for the pharmacy industry for a declared emergency

Documents | Guides and Templates | Informational

NCPDP Emergency Preparedness Guidance v.1.15

NCPDP Emergency Preparedness Guidance v.1.15

2022 updates to the NCPDP Emergency Preparedness Guidance document

Press Releases

NCPDP Announces Call for Proposals for its 2023 Annual Technology & Business Conference, “The Great Race to Close Gaps in Care”

NCPDP Announces Call for Proposals for its 2023 Annual Technology & Business Conference, “The Great Race to Close Gaps in Care”

NCPDP announced today the call for proposals for its 2023 Annual Technology & Business Conference, “The Great Race to Close Gaps in Care,” which will be held May 8-10, 2023, at the Westin Kierland Resort & Spa in Scottsdale, Arizona.

Documents | Guides and Templates

X12N 835 Payment Guidance and Related Documents - Mapping Document

X12N 835 Payment Guidance and Related Documents - Mapping Document

WG45 External Standards Assessment, Harmonization and Implementation Guidance Work Group has prepared a mapping document for consistent use of the Claim Adjustment Reason Codes (CARC), Claim Adjustment Group Codes (CAGC) and NCPDP Reject Codes in the X12 835.

Documents | Guides and Templates | Informational

NCPDP Processor ID (BIN)

NCPDP Processor ID (BIN)

The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. Plans that use cards with a magnetic stripe should use the recommended American National Standards Institute (ANSI)ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. ANSI The ISO/IEC 7812 Registration Authority (the American Bankers Association) issues the IIN. numbers. NCPDP issues the Processor ID Number (BIN). It is important to understand the difference between the ISO/IEC 7812 IIN and NCPDP Processor ID Number (BIN) before applying for a Processor ID Number (BIN).

Guides and Templates

NCPDP Processor ID (BIN)

NCPDP Processor ID (BIN)

The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. Plans that use cards with a magnetic stripe should use the recommended American National Standards Institute (ANSI) Issue Identifier Number (IIN) for processing electronic pharmacy claims. ANSI issues IIN numbers. NCPDP issues the Processor ID Number (BIN). It is important to understand the difference between the IIN and NCPDP Processor ID Number (BIN) before applying for a Processor ID Number (BIN).

Guides and Templates

Use of the BIN - NCPDP Processor ID

Use of the BIN - NCPDP Processor ID

The Bank Identification Number (BIN) is a term from the credit card industry. It refers to a six-digit number that is assigned to banks for electronic routing of transactions. Credit/debit cards that are involved in banking transactions contain a BIN on magnetic stripe. The term BIN is no longer supported. The number is now called an Issuer Identification Number (IIN). As of January 2017, the IIN length has changed from a 6-digit number to an 8-digit number. Existing six-digit IINs will be converted into a block of a hundred eight-digit IINs. As the majority of issuers are unlikely to need all one hundred of these, they are encouraged to return any unused eight-digit IINs to ANSI.

Guides and Templates

Issuer Identification Number - NCPDP Processor ID (BIN)

Issuer Identification Number - NCPDP Processor ID (BIN)

To obtain an IIN, please contact the American National Standards Institute (ANSI) www.ansi.org. On the ANSI web page, enter "IIN" in the Search box. Links will appear for the application process.  ANSI is responsible for making certain the application has been properly completed and that all appropriate fees and attachments have been collected.  Once verified, ANSI will submit the application to the ISO/IEC7812 Registration Authority for assignment of an IIN.

Guides and Templates

Processor Identification Number (Processor BIN) - NCPDP Processor ID (BIN)

Processor Identification Number (Processor BIN) - NCPDP Processor ID (BIN)

In approximately 1989 the pharmacy services sector began using electronic processing for pharmacy claims. This electronic processing of pharmacy claims meant the health plan (or their Pharmacy Benefit Manager/processor/payer on their behalf) needed a number for the electronic routing of transactions. Some health plans decided to use magnetic stripe cards, some did not. Those that use magnetic stripe cards apply through ANSI for an IIN. These numbers commonly begin with "61" as in "610014". Those health plans that did not have a business reason for creating pharmacy benefit cards with a magnetic stripe were in need of a number, because they still needed to process electronic pharmacy claims. NCPDP provides a service to those health plans that do not use magnetic stripe cards. The NCPDP Processor BIN is a six-digit sequential number we assign that begins with "0" as in "000010". We do not reuse numbers. There is a fee to obtain a number.

Documents | Guides and Templates

How to Obtain a Processor ID (BIN) - NCPDP Processor ID (BIN)

How to Obtain a Processor ID (BIN) - NCPDP Processor ID (BIN)

Contact NCPDP Provider Services Department at 480.734.2870 or PharmacyHelp@ncpdp.org, or complete a Processor ID Application. Your number will be assigned and notification will be delivered via fax or email.

Guides and Templates

IIN/Processor Identification Number (Processor BIN) Use - NCPDP Processor ID (BIN)

IIN/Processor Identification Number (Processor BIN) Use - NCPDP Processor ID (BIN)

When a patient requests a prescription to be filled at the pharmacy, the pharmacy collects pertinent information on their prescription benefit program. One piece of information is the name of the health plan/PBM. If the health plan uses the NCPDP Pharmacy ID and Combination Card Implementation Guide that NCPDP members have created, the BIN/IIN is clearly shown on the card. The pharmacy system then includes this BIN/IIN in the electronic transaction the pharmacy sends to the payer for the prescription. The BIN/IIN is a field in the Telecommunication Standard that is used for the routing and identification in pharmacy claims. The BIN/IIN field will either be filled with the ISO/IEC 7812 IIN or the NCPDP Processor BIN, depending on which one the health plan has obtained.

News

Kristol Chism, R.Ph., is announced as the 2022-2023 Emerging Professional Fellow

Kristol Chism, R.Ph., is announced as the 2022-2023 Emerging Professional Fellow

The Strategic Planning Committee (SPC) and Emerging Professionals Group is proud to announce Kristol Chism, R.Ph. with Change Healthcare as the incoming Emerging Professionals Fellow.

Documents | Informational

Get Familiar with NCPDP’s "Swim Lane Analysis"

Get Familiar with NCPDP’s "Swim Lane Analysis"

This is a tool being used to identify and explore possible ways to streamline processes in support of our strategic goal to increase the speed to standards creation.

White Papers

Facilitating Access to Specialty Products An NCPDP Review and Recommendations White Paper

Facilitating Access to Specialty Products An NCPDP Review and Recommendations White Paper

This paper offers recommendations to manufacturers, prescribers, payers and pharmacies regarding the information related to hub services and limited distribution products.

Guides and Templates | Informational

Specialty Pharmacy Resources

Specialty Pharmacy Resources

If you would like to participate, you can work collaboratively with colleagues and competitors alike to advance health information technology solutions through NCPDP’s consensus-building process for Specialty prescriptions. Your voice impacts your business and provides value to both you and your company. View Resources at https://ncpdp.org/Specialty-Pharmacy

Press Releases

NCPDP Announces Recipients of its 2022 Champion Award

NCPDP Announces Recipients of its 2022 Champion Award

Lori Moore, PharmD, CAPT United States Public Health Service (USPHS), and Paloma L. Hawry, CDC Contractor, Deloitte Consulting | Federal Healthcare, are Recognized as NCPDP Champions

Press Releases

NCPDP Announces Highlights from its 2022 Annual Conference, “BE BOLD. Break Barriers.”

NCPDP Announces Highlights from its 2022 Annual Conference, “BE BOLD. Break Barriers.”

Highlights Include Newly Elected Board Members, Announcement of Award Recipients, Keynoters and Featured Speakers Headlining the Conference, and State of the Association Report

Documents

Steps for Standards Compliance

Steps for Standards Compliance

Document identifies NCPDP steps should a suspected misapplication of an NCPDP Standard be introduced.

Documents | Informational

Industry Acronym Dictionary

Industry Acronym Dictionary

If you would like to suggest an acronym, please send an email to NCPDP@ncpdp.org with subject line "Suggested Acronym".

Informational

Press Releases

NCPDP Announces Dr. Jerome Adams as Opening Keynoter for Its 2022 Annual Conference, “BE BOLD. Break Barriers.”

NCPDP Announces Dr. Jerome Adams as Opening Keynoter for Its 2022 Annual Conference, “BE BOLD. Break Barriers.”

20th U.S. Surgeon General, Dr. Adams Will Highlight Lessons Learned from a Life Dedicated to Breaking Through Healthcare, Institutional & Socioeconomic Barriers

Documents | Guides and Templates | Informational

Emergency Preparedness

Emergency Preparedness

This page provides guidance to the pharmacy industry for resources available during a declared emergency. The intended audience is healthcare industry providers who would need resource information for eligibility and claims processing affecting displaced individuals.

Documents | Guides and Templates | Informational

ePrescribing Industry Information

ePrescribing Industry Information

Information about electronic prescribing, standards and reference material from the industry

Documents

NCPDP Bylaws

NCPDP Bylaws

This document contains the rules related to the management of the National Council for Prescription Drug Programs’ internal operations.

Press Releases

NCPDP to Explore VBAs for Prescription Medications at its Virtual Educational Summit, November 15-16, 2021

NCPDP to Explore VBAs for Prescription Medications at its Virtual Educational Summit, November 15-16, 2021

Event to feature drivers of value-based arrangements for prescription medications and showcase multiple stakeholder perspectives on the current state of VBAs, challenges, opportunities, and standards that support VBAs

Documents

NCPDP Standards Matrix

NCPDP Standards Matrix

The following is a high-level overview of the latest version/release and/or the most commonly used of those standards and implementation guides, as well as NCPDP’s Data Dictionary and External Code List. Additionally, this document provides version/release/publication reference charts for approved and draft NCPDP standards/implementation guides.

Documents | Guides and Templates | Informational

Press Releases

NCPDP Announces Call for Proposals for its 2022 Annual Technology & Business Conference, “Be BOLD. Break Barriers.”

NCPDP Announces Call for Proposals for its 2022 Annual Technology & Business Conference, “Be BOLD. Break Barriers.”

NCPDP announced today the call for proposals for its 2022 Annual Technology & Business Conference, “Be BOLD. Break Barriers.,” which will be held May 2-4, 2022, at the Westin Kierland Resort & Spa in Scottsdale, Arizona. Deadline to submit a proposal is October 4, 2021

Documents | Guides and Templates

RTPB Standard Implementation Recommendations v 1.1

RTPB Standard Implementation Recommendations v 1.1

The NCPDP Real-Time Prescription Benefit (RTPB) Implementation Recommendations document is intended to provide further clarification on the use of specific data elements, segments and communication protocol in order to facilitate standardization in implementation of the Standard and achieve the expected outcomes.

Documents | Guides and Templates

Background and Guidance for Using the NCPDP Standards for Digital Therapeutics

Background and Guidance for Using the NCPDP Standards for Digital Therapeutics

This document provides guidance on the use of NCPDP Standards for the ordering and fulfillment of Digital Therapeutic products and services.

Press Releases

STChealth Joins Forces with NCPDP on Interoperable Solution to Address Public Health Crises

STChealth Joins Forces with NCPDP on Interoperable Solution to Address Public Health Crises

STChealth and NCPDP today announced their strategic alliance to operationalize NCPDP’s National Facilitator Model which can provide pharmacists and prescribers with real-time prescription, testing, immunization, and related information at the point of care to support patient health interventions during public health crises such as COVID-19 and the opioid epidemic.

White Papers

Standardized Medication Profile

Standardized Medication Profile

The HL7/NCPDP Standardized Medication Profile white paper.

White Papers

NCPDP GS1 DataMatrix White Paper

NCPDP GS1 DataMatrix White Paper

This White Paper discusses the issues associated with removal of the GS1 UPC-A and provides recommendations in supporting the requirements for manufacturers to affix or imprint the new product identifier to each package and homogenous case of a product.

Press Releases

NCPDP Announces New Senior Vice President, Innovation, Richard Sage

NCPDP Announces New Senior Vice President, Innovation, Richard Sage

Newly Created Executive Position to Focus on Growth Opportunities Aligned with NCPDP’s Strategic Plan

Press Releases

Press Releases

NCPDP Announces Recipients of its 2021 Champion Award

NCPDP Announces Recipients of its 2021 Champion Award

Ken Hill, R.Ph., and Charlie Oltman, MBA, CHC, are Recognized NCPDP Champions

Press Releases

FDB Joins NCPDP’s Elite Partner Program

FDB Joins NCPDP’s Elite Partner Program

FDB Formalizes its Decades-long Support of NCPDP, with a 3-Year Commitment of Sustained Support with the Shared Goals of Patient Safety

White Papers

Controlled Substance - Quantity Prescribed White Paper

Controlled Substance - Quantity Prescribed White Paper

The purpose of this white paper is to provide information and guidance on the use of the Quantity Prescribed (460-ET) field to address the Schedule II controlled substances (CII’s) billing issues identified in the September 2012 OIG report and to address issues with state requirements related to CII’s for dispensing of medication in increments less than the amount prescribed.

White Papers

Qualified Medicare Beneficiary Part B Coordination of Benefit Barriers and Recommendations

Qualified Medicare Beneficiary Part B Coordination of Benefit Barriers and Recommendations

The purpose of this document is to provide electronic data solutions to current barriers for processing claims secondary to a Medicare Part B benefit for Qualified Medicare Beneficiary (QMB) Program participants that align with QMB Program requirements.

Documents | White Papers

NCPDP Recommendations and Guidance for Standardizing the Dosing Designations on Prescription Container Labels of Oral Liquid Medications

NCPDP Recommendations and Guidance for Standardizing the Dosing Designations on Prescription Container Labels of Oral Liquid Medications

This paper provides the healthcare industry, in particular the pharmacy sector, with historical and background information on the patient risks associated with the dosing of liquid medications and recommendations to mitigate those risks through best practices in prescription orders, prescription labeling and the provision of dosing devices.

Presentations

Maximize Your Member Portal Presentation - February 4, 2021 Brown Bag Session

Maximize Your Member Portal Presentation - February 4, 2021 Brown Bag Session

Presentation given at February 4, 2021 Work Group Brown Bag Session. Discusses how to navigate NCPDP websites.

Documents | Guides and Templates

Medicare Part D

Medicare Part D

Medicare Part D and Payers Supplemental to Part D

Presentations

Focus on Pharmacy Compliance and Independent Pharmacy Credentials with resQ Presentation

Focus on Pharmacy Compliance and Independent Pharmacy Credentials with resQ Presentation

Join Dave Mammen, Account Executive, for a presentation and product demo of resQ, Pharmacy Credentialing Resource. This was previously recorded for our 2020 Virtual Product Showcase. https://www.youtube.com/watch?v=vzHeddTdcOs

Presentations

Keep Your NCPDP Standards Updated Easily with NCPDP Standards Table Data Presentation

Keep Your NCPDP Standards Updated Easily with NCPDP Standards Table Data Presentation

This video gives an overview of the NCPDP Standards Table Data. NCPDP Standards Table Data is a comma-separated, machine-readable, comma-separated data file format that can be imported into existing computer applications and databases by IT developers. https://www.youtube.com/watch?v=cA2vXdks1kw

Presentations

Mitigate Compliance Risk and Exposure for Prescription Transactions with HCIdea

Mitigate Compliance Risk and Exposure for Prescription Transactions with HCIdea

Learn more about NCPDP's HCIdea Prescriber Database. This presentation was led by Mia Ricci, National Account Executive and NCPDP's Virtual Product Showcase in November 2020. Learn more about NCPDP's HCIdea Prescriber Database. This presentation was led by Mia Ricci, National Account Executive and NCPDP's Virtual Product Showcase in November 2020. www.youtube.com/watch?v=scD-voOoWgs

Presentations

Improving Pharmacy Data Accuracy using dataQ Pharmacy Database

Improving Pharmacy Data Accuracy using dataQ Pharmacy Database

Join Dave Mammen, Account Executive, for a product demo and presentation on dataQ. This was previously recorded during our 2020 Virtual Product Showcase. https://www.youtube.com/watch?v=sb9UdFr-B-A

Presentations

RxReconn State and Federal Legislatione and Regulatory Online Tracking Tool Overview

RxReconn State and Federal Legislatione and Regulatory Online Tracking Tool Overview

Get real-time access to industry related issues with the NCPDP state and federal legislative and regulatory online tracking tool, RxReconn. Watch to learn all the benefits of RxReconn. https://www.youtube.com/watch?v=d8lJ5x_xy-I

White Papers

NCPDP Specialty Pharmacy Benefit Coverage Identification White Paper 

NCPDP Specialty Pharmacy Benefit Coverage Identification White Paper 

The purpose of this white paper is to highlight current challenges experienced by providers, specialty pharmacies and organizations in being able to timely and accurately identify the appropriate benefit coverage (medical or pharmacy benefit) for a specific medication being prescribed, as well as potential out-of-pocket costs to the patient at the time of care. Overall, the desired outcome of benefit identification is to provide a comprehensive benefit coverage overview electronically at the time the medication is selected and to improve a patient’s ability to begin therapy without delay. This process should be easily accessible without multiple manual steps or duplication of efforts by providers, specialty pharmacies and hubs.

Documents | Guides and Templates | White Papers

NCPDP Standards-based Facilitated Model for PDMP: Phase I and II

NCPDP Standards-based Facilitated Model for PDMP: Phase I and II

The white paper has been updated to add Phase II which supports real-time reporting and risk response in addition to Phase I functionality. The facilitated model leverages current industry technology and clinical expertise to create and/or communicate potential risks using an algorithm (e.g., risk score). The facilitated model also supports prescribers and dispensers with information to assist in making an appropriate clinical decision.

Documents | Guides and Templates

Prescription Drug Monitoring Programs (PDMP) Resources

Prescription Drug Monitoring Programs (PDMP) Resources

Nearly all states have enacted laws to establish PDMPs, electronic databases to collect data on controlled substances dispensed or prescribed within their jurisdictions. However, the absence of business rules governing or allowing sharing of information from state to state and across pharmacies, lack of interoperability among the operational PDMPs, and variation in the timeliness of data reporting make it difficult for states and law enforcement to prevent misuse, abuse and fraud.

Documents

NCPDP Standard Operating Procedures

NCPDP Standard Operating Procedures

This document contains the procedures related to the structure and standards setting process of the National Council for Prescription Drug Programs.

Documents

Data Element Request Form (DERF)

Data Element Request Form (DERF)

The Data Element Request Form (DERF) is the documentation used to request an addition or modification to an NCPDP standard. Anyone may submit a DERF to NCPDP along with accompanying information, including the proposed standard, implementation guide, data element dictionary, and modification log if needed. A DERF must be completed and submitted with the proper documentation prior to the next quarterly work group meetings for it to be reviewed during those meetings. The DERF is distributed to NCPDP members via the NCPDP website before the work group meeting.

Documents | Guides and Templates

NCPDP Quantity Prescribed (460-ET) Implementation Timeline Guidance

NCPDP Quantity Prescribed (460-ET) Implementation Timeline Guidance

This paper offers guidance to the pharmacy industry in preparing for the implementation of CMS-0055-F, which requires the Quantity Prescribed (460-ET) field for all Schedule II drugs.

Documents | Guides and Templates

Quantity Prescribed (460-ET) Guidance

Quantity Prescribed (460-ET) Guidance

The final rule CMS-0055-F published on January 24, 2020, adopts a modification of the requirements for the use of the Telecommunication Standard Implementation Guide, Version D, Release 0 (Version D.0), August 2007, National Council for Prescription Drug Programs, by requiring covered entities to use the Quantity Prescribed (460-ET) field for retail pharmacy transactions for Schedule II drugs. This change constitutes a modification to the use of the adopted standard, not a modification to the standard itself. Click for more details.

Webinars

From Months to Minutes – Advancements in Standards, Innovations Increasing Speed to Therapy in the Most Challenging Prescribing Workflows

From Months to Minutes – Advancements in Standards, Innovations Increasing Speed to Therapy in the Most Challenging Prescribing Workflows

The presentation will describe how today’s standards and innovations are getting therapies to patients not in months, but in minutes. Efficiencies occurring in the trenches of care delivery will be discussed along with lessons learned about filling workflow gaps that still exist today.

Informational

Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements

Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements

CMS published a proposed rule “Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements.” The proposed rule seeks to promote value-based payments for prescription drugs and assess pharmacy benefit manager (PBM) accumulator programs and their impact on calculating average manufacturer price (AMP) and implement standards that would enhance a states’ ability to identify or limit inappropriate prescribing of opioids if a beneficiary is already receiving medication assisted treatment for substance use disorder (SUD).