The Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018 (HR 4841) was recently introduced. The bill would require Medicare Part D plans to approve electronic prior authorization requests for prescription coverage.
Under this bill, prescribers could send requests to payers electronically, and payers could then transmit those decisions, effective Jan 1, 2020. The bill would also require HHS to create standards defining electronic transmissions and specifically references NCPDP:
(II) STANDARDS .—In order to be treated, for purposes of this sub-paragraph, as an electronic transmission described in clause (i), such transmission shall comply with technical standards adopted by the Secretary in consultation with the National Council for Prescription Drug Programs, other standard setting organizations determined appropriate by the Secretary, and stakeholders including PDP sponsors, Medicare Advantage organizations, health care professionals, and health information technology software vendors.’’