Comment

NCPDP Comment

  1. NCPDP recommends that ONC update: NCPDP Telecommunication Standard, Implementation Guide, Version F2, March 2018 and Equivalent Batch Standard Implementation Guide, Version 15 to NCPDP Telecommunication Standard, Implementation Guide Version F6, April 2022 and equivalent Batch Standard Implementation Guide Version 15
  2. NCPDP recommends that ONC update: NCPDP Batch Standard Medicaid Subrogation Implementation Guide, Version 3, Release 0 (Version 3.0), July 2007 to NCPDP Batch Standard Medicaid Subrogation Implementation Guide Version 3.0
  3. NCPDP recommends that ONC update: NCPDP Batch Standard Medicaid Subrogation Implementation Guide, Version 10 to NCPDP Batch Standard Subrogation Implementation Guide Version 10
  4. NCPDP recommends that ONC remove: HL7® FHIR® DaVinci Provider Data Exchange (PDex: Formulary) Implementation Guide. The guide does not support pharmacy claims submission nor is it adopted under HIPAA.
  5. NCPDP recommends that ONC update the Limitations, Dependencies, and Preconditions for Consideration section to remove: Information about the CMS May 2020 Interoperability and Patient Access final rule and the HL7 FHIR APIs included in that rule may be found on the CMS Interoperability website. This rule includes use of the HL7® FHIR® DaVinci Provider Data Exchange (PDex: Formulary) Implementation Guide.
    1. Rationale: You cannot submit a claim using the HL7® FHIR® DaVinci Provider Data Exchange (PDex: Formulary) Implementation Guide. This guide possibly belongs under the section “Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems”; however, the purpose of the guide is to allow a consumer to verify formulary and benefit information.

Pharmacy HIT Collaborative (PHIT) comment

PHIT supports the following NCPDP recommendations: updating NCPDP Telecommunication Standard, Implementation Guide, Version F2, March 2018 and Equivalent Batch Standard Implementation Guide, Version 15 to NCPDP Telecommunication Standard, Implementation Guide, Version F6, April 2022 and Equivalent Batch Standard Implementation Guide, Version 15; updating NCPDP Batch Standard Medicaid Subrogation Implementation Guide, Version 3, Release 0 (Version 3.0), July 2007 to NCPDP Batch Standard Medicaid Subrogation Implementation Guide Version 3.0; and updating NCPDP Batch Standard Medicaid Subrogation Implementation Guide, Version 10 to NCPDP Batch Standard Subrogation Implementation Guide Version 10.

NCPDP Comments

  1. NCPDP recommends updating: NCPDP Batch Standard Medicaid Subrogation Implementation Guide, Version 10 to the following:
    1. NCPDP Subrogation Implementation Guide for Batch Standard Version 10

 

  1. NCPDP recommends updating: NCPDP Telecommunication Standard, Implementation Guide, Version F2, March 2018 and Equivalent Batch Standard Implementation Guide, Version 15 to the following:
    1. NCPDP Telecommunication Standard Implementation Guide, Version F6, April 2022 and equivalent Batch Standard Implementation Guide Version 15

 

  1. NCPDP recommends removing the following:
    1. Standard / Implementation Specification: HL7® FHIR® DaVinci Provider Data Exchange (PDex: Formulary) Implementation Guide and
    2. Limitations, Dependencies, and Preconditions for Consideration: Information about the CMS May 2020 Interoperability and Patient Access final rule and the HL7 FHIR APIs included in that rule may be found on the CMS Interoperability website. This rule includes use of the HL7® FHIR® DaVinci Provider Data Exchange (PDex: Formulary) Implementation Guide.
      1. Rationale: You cannot submit a claim using the HL7® FHIR® DaVinci Provider Data Exchange (PDex: Formulary) Implementation Guide. This guide possibly belongs under the section “Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems”; however, the purpose of the guide is to allow a consumer to verify formulary and benefit information.

NCPDP Comment

  1. Add the following:

Type-Implementation Specification

Standard Implementation/Specification- NCPDP Telecommunication Standard, Implementation Guide, Version F2, March 2018 and Equivalent Batch Standard Implementation Guide, Version 15

Standards Process Maturity – Final

Implementation Maturity- Pilot

Adoption Level – 1

Federally Required – No

Cost – $

Test Tool Availability – No.

 

Limitations, Dependencies, and Preconditions for Consideration

 

  • The Telecommunication Standard Implementation Guide Version F2 has been requested to be adopted under HIPAA.
  • NCPDP is in the investigative stage of providing a test tool.
  •  

NCPDP - Comment

    • The Standard Listed – NCPDP Version D.0 is incorrect. The Standard and Implementation Guide are not separated. There is no separate standard and the Standard section material should be deleted.
    • Standard Implementation/Specification: incorrectly lists the wrong version of the Telecommunication Standard Implementation Guide. It should be Telecommunication Standard Implementation Guide, Version D, Release 0 (Version D.0), August 2010.