Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Adoption Level	Federally required	Cost	Test Tool Availability
Implementation Specification	NCPDP® Formulary and Benefit Standard Version 3.0	Final	Production		Yes	$	No
Implementation Specification	NCPDP Real Time Prescription Benefit Standard Version 12	Final	Production		No	$	No
Implementation Specification	NCPDP Formulary and Benefit Standard Version 53	Final	Feedback requested	Feedback Requested	No	$	No
Implementation Specification	NCPDP Formulary and Benefit Standard Version 54	Final	Feedback requested	Feedback Requested	No	$	No
Implementation Specification	NCPDP Formulary and Benefit Standard Version 55	Final	Feedback requested	Feedback Requested	No	$	No

Limitations, Dependencies, and Preconditions for Consideration	Applicable Security Patterns for Consideration
Feedback requested.	Secure Communication – Create a secure channel for client-to- serve and server-to-server communication. Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery. Authentication Enforcer – Centralized authentication processes. Authorization Enforcer – Specifies access control policies. Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos). Assertion Builder – Define processing logic for identity, authorization and attribute statements. User Role – Identifies the role asserted by the individual initiating the transaction. Purpose of Use - Identifies the purpose for the transaction.

Limitations, Dependencies, and Preconditions for Consideration

Applicable Security Patterns for Consideration

Feedback requested.

Secure Communication – Create a secure channel for client-to- serve and server-to-server communication.
Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery.
Authentication Enforcer – Centralized authentication processes.
Authorization Enforcer – Specifies access control policies.
Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos).
Assertion Builder – Define processing logic for identity, authorization and attribute statements.
User Role – Identifies the role asserted by the individual initiating the transaction.
Purpose of Use - Identifies the purpose for the transaction.

Comment

Submitted by pwilson@ncpdp.org on 2022-09-30

NCPDP Comments

NCPDP recommends updating – NCPDP Formulary and Benefit Standard Version 53 to the following:

NCPDP Formulary and Benefit Standard Version 60

Submitted by pwilson@ncpdp.org on 2021-09-29

NCPDP Comments

For NCPDP Real-Time Prescriptions Benefit Standard, add “Version 12” to the Standard/Implementation Specification title.

Submitted by pwilson@ncpdp.org on 2020-11-07

NCPDP Comment

Remove existing NCPDP verbiage under “Limitations”.
Add the following:

Type-Implementation Specification Standard Implementation/Specification- NCPDP Formulary and Benefit Standard, Implementation Guide, Version 53 Standards Process Maturity – Final Implementation Maturity – Feedback requested Adoption Level – Feedback requested Federally required – No Cost - $ Test Tool Availability – No

Modify the following:

Type-Implementation Specification Standard Implementation/Specification- NCPDP Real Time Prescription Benefit Standard Standards Process Maturity – Final Implementation Maturity – Production Adoption Level – 1

Submitted by pwilson@ncpdp.org on 2019-09-23

NCPDP Comment

NCPDP developed a Beta version of the Real Time Prescription Benefit Standard to be balloted in the Fall of 2019.

Submitted by mattreid on 2019-09-23

Real Time Prescription Benefit

The American Medical Association appreciates the opportunity to comment. Real-time Prescription Benefit (RTPB) is mentioned, however it is not linked nor actually named. We believe this section should be updated as RTPB now has a standard out for ballot.

Submitted by pwilson@ncpdp.org on 2017-11-20

NCPDP - Comment

The second bullet under Limitations, Dependencies, and Preconditions for Consideration should be modified to the following:
- NCPDP is developing a Real Time Prescription Benefit standard that should be monitored as a potential emerging implementation specification.

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Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems

Comment

NCPDP Comments

NCPDP Comments

NCPDP Comment

NCPDP Comment

Real Time Prescription Benefit

NCPDP - Comment