News

THE NATIONAL COUNCIL FOR PRESCRIPTION DRUG PROGRAMS (NCPDP) ANNOUNCES CALL FOR NOMINATIONS FOR 2009 BOARD OF TRUSTEES
MINNESOTA TO RELEASE NOTICE OF COMPANION GUIDES FOR CURRENT PROCESSING
IMPORTANT COMPOUND FEEDBACK NEEDED
REQUEST FOR SCRIPT STANDARD IN FUTURE MMA REGULATIONS
TERESA STRICKLAND JOINS NCPDP STAFF
HITSP WEBINAR SERIES ON HEALTHCARE IT INTEROPERABILITY
CMS EXTENDS EPRESCRIBING EXEMPTION
NHIN FORUM COMING IN MID-DECEMBER
AHRQ ISSUES HEALTH IT FUNDING OPPORTUNITIES
NCPDP ACCEPTING CALL FOR APPLICATIONS FOR STANDARDIZATION CO-CHAIRS
AHIC RELEASES BYLAWS DRAFT AND CALLS FOR NEW CEO
HIPAA PREPARATION
PRIVACY GUIDANCE ISSUED BY HHS OCR
NCPDP STANDARDS NAMED IN HIPAA
AHIC SEEKS PUBLIC COMMENTS
NCPDP PAYER SHEET TEMPLATE
X12 RESPONDS TO NPRM
RULES PROPOSED FOR CLAIM PAYMENT REMITTANCE
MINNESOTA UNIFORM COMPANION GUIDES
NCVHS RECOMMENDS EPRESCRIBING CHANGES FOR LONG TERM CARE
EPRESCRIBING MANDATED IN MINNESOTA
NEXT ROUND OF HIPAA TRANSACTIONS - ARE YOU READY?
NCPDP LAUNCHES DATAQ, A NEXT GEN PHARMACY DATABASE RESOURCE PROVIDING REAL-TIME ACCESS AND CUSTOMIZED REPORTING
UPDATED VERSION 5 EDITORIAL DOCUMENT PUBLISHED
NCPDP BYLAWS AND STANDING OPERATING PROCEDURES APPROVED
CMS RELEASES PART D E-PRESCRIBING FINAL RULE
NCPDP PROVIDES MEDICAID AGENCIES WITH HCIDEA™ PRESCRIBER DATABASE - WAIVES LICENSE FEE
NCPDP PUBLISHES LONG-TERM CARE REBATE REPORTING GUIDANCE
NCVHS RECOMMENDS STANDARDS MOVE FORWARD UNDER HIPAA

THE NATIONAL COUNCIL FOR PRESCRIPTION DRUG PROGRAMS (NCPDP) ANNOUNCES CALL FOR NOMINATIONS FOR 2009 BOARD OF TRUSTEES Article

The NCPDP Nominating Committee is calling on the membership for nominations for the 2009 Board of Trustees election. Participation on the Board offers an opportunity to be involved in high level decision-making and to take part in shaping the Council's future. To be eligible for nomination, an individual must have demonstrated involvement and/or leadership in NCPDP or the healthcare industry in areas related to the Council and must be a member in good standing for at least two (2) years.

As an NCPDP Board Trustee, every effort will be made to attend the NCPDP work group meetings. The leadership of NCPDP must be present to assist in the direction of the work groups. In addition, Board participation in these meetings, provides insight and a better understanding of current issues once they reach the Board's meeting agenda for discussion and/or approval. The Board of Trustees retains final authority over the Council's standardization efforts.

Responsibilities of the Board include: Each newly elected Board member will serve a term of three (3) years. The nomination and election process is handled electronically to encourage greater participation by the NCPDP membership.

The Council will have one (1) opening in the Producer/Provider (pink) category, two (2) openings in the Payer/Processor (green) category and two (2) openings in the Vendor/General Interest (yellow) category. Nominations must include: name of nominee, title, company, address, phone number, fax number and email address. You may submit a nomination electronically by sending an email message to Joanne Longie at jlongie@ncpdp.org. Nomination submissions will be accepted through December 31, 2008.


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MINNESOTA TO RELEASE NOTICE OF COMPANION GUIDES FOR CURRENT PROCESSING Article

Minnesota will be publishing notice of proposed technical changes to the claims companion guides on 12/22/2008. This notice will be in the state register (http://www.comm.media.state.mn.us/bookstore/state_register.asp), with links on the following sites:
http://www.health.state.mn.us/asa/index.html
http://www.health.state.mn.us/auc/index.html

There will be 30 calendar days for comments to be submitted. The technical changes will address items such as front matter harmonization, Not Considered for Processing (NCFP) designation, and technical comments submitted. The claims companion guides have been built to be the guides required for use by group purchasers and health care providers doing business in MN. These companion guides affect the ASC X12N version 4010A1 transactions and the NCPDP Telecommunication Version 5.1 transactions.NCPDP will be resubmitting the technical comments posted on the website
http://www.ncpdp.org/members/members_government_state.asp.


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IMPORTANT COMPOUND FEEDBACK NEEDED Article

Requirement for multi-ingredient compounds - Representatives of the industry have discussed concerns with the department over the proposed requirement that the MN companion guide allows only the multi-ingredient Compound option (Compound Segment) for Telecommunication version 5.1. The other methods of processing compounds currently allowed in Telecommunication 5.1 would not be allowed. This requirement would be required 07/15/2009. With the notice, the State is looking for detailed comments from the industry of the impact of moving to only one method of compound billing in the current environment, rather than waiting until the Telecommunication Standard version D.0 is named in HIPAA and only supports the one method. This proposed requirement could cause modifications to existing systems, which could impact the analysis underway for preparing for the next HIPAA version.


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REQUEST FOR SCRIPT STANDARD IN FUTURE MMA REGULATIONS Article

Based on recommendations from participants in NCPDP Work Group 11 ePrescribing and Related Transactions, the recommendation has been made to the National Committee on Vital and Health Statistics (NCVHS) to proceed to the SCRIPT Standard Implementation Guide Version 10.6 by January 2010. The SCRIPT Standard Implementation Guide Version 10.6 supports the functionality of previous versions while supporting additional functionality, including needs identified by the long-term care industry. See the recommendation letter at http://www.ncpdp.org/members/members_government_federal.asp#epres


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TERESA STRICKLAND JOINS NCPDP STAFF Article

On January 5, 2009, Teresa Strickland will be joining NCPDP as Technical Advisor, Standards Development. Strickland brings a wealth of technical practical implementation and analysis in the industry. She has been a member of NCPDP for almost 9 years. She is experienced in NCPDP and X12 standards, as well as exposure to HL7. We welcome her to NCPDP staff.


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HITSP WEBINAR SERIES ON HEALTHCARE IT INTEROPERABILITY Article

The Healthcare Information Technology Standards Panel (HITSP) is identifying the standards that will support the exchange of healthcare information across the United States. Learn more about the Panel and how you can engage in shaping the future of healthcare information technology (HIT) interoperability during a series of free webinars that will be held on the third Thursday of each month during 2009.

The first program in the series will be held Thursday, January 15, 2009 from 2:00 - 3:30 p.m. Eastern Time. This 90-minute program will highlight the 2008 accomplishments of the panel, the latest initiatives in HIT standards harmonization, the relationship of HITSP to AHIC2, and provide an introduction to future priority areas of HIT harmonization.

For more information, click here.


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CMS EXTENDS EPRESCRIBING EXEMPTION Article

Following the publication of the CY 2008 MPFS final rule with comment period, CMS received additional feedback from pharmacies and others in industry regarding the economic and workflow impact of removing the computer generated fax exemption. After careful consideration of this feedback, and coupled with the new incentives for prescribers provided in MIPPA, CMS has reconsidered the electronic prescribing exemption for computer generated facsimiles.

In the interest of patient care and safety, and to encourage prescribers and dispensers to adopt ePrescribing, CMS is reversing the modifications to the computer generated facsimile exemption in the CY 2008 MPFS final rule with comment period and reinstating the original computer-generated facsimile exemption that was adopted in the November 7, 2005 ePrescribing final rule, effective January 1, 2009. However, CMS will also eliminate the reinstated exemption for computer-generated facsimiles in all instances other than transient/temporary network transmission failures when the MIPPA ePrescribing program disincentives take effect on January 1, 2012.

Please see pages 325 to 356 of the 2009 Medicare Physician Fee Schedule to review the full discussion on this topic.


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NHIN FORUM COMING IN MID-DECEMBER Article

The Department of Health and Human Services (HHS) will present a free forum will showcase the work of the NHIN Cooperative, including demonstrations, experiences, and lessons learned from the Trial Implementations. The 5th NHIN Forum will be held December 15 - 16, 2008 in Washington, DC.

This forum will showcase the work of the NHIN Cooperative, including experiences and lessons learned from the Trial Implementations, including: To Register for this Event: www.blsmeetings.net/nhinf


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AHRQ ISSUES HEALTH IT FUNDING OPPORTUNITIES Article

New health IT funding opportunities announced by AHRQ will help achieve improvements in quality and safety in ambulatory settings and transitions of care.

The types of funding opportunities include: To Learn more about these funding opportunities: Click Here


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NCPDP ACCEPTING CALL FOR APPLICATIONS FOR STANDARDIZATION CO-CHAIRS Article

Per Section 6.4.2 of the Bylaws, NCPDP is announcing the Call for Applications of Standardization Co-Chairs. The application timeframe is open until December 15, 2008. The Board of Trustees will approve the appointments in January.

To be eligible for application: An individual has demonstrated involvement and/or leadership in NCPDP or the health care industry in areas related to the Council and must be a member. Please see the Members "Leadership Opportunities" page under "Standardization Committee" http://www.ncpdp.org/members/members_leader.asp for the application information.


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AHIC RELEASES BYLAWS DRAFT AND CALLS FOR NEW CEO Article

The AHIC Successor, Inc. is preparing bylaws to guide the new organization. The bylaws, currently in draft, are based on the vision and principles developed through multiple open and transparent steps over the past 18 months, culminating in the work of the AHIC Successor’s Governance Planning Group. The bylaws will represent another important milestone in creating a vibrant multi-stakeholder public-private organization that can drive interoperable health information technology forward.

The AHIC Successor is also seeking a chief executive officer (CEO) to continue the organization’s mission in developing interoperable health information technology.

The draft bylaws and CEO solicitation can be found on the AHIC Successor’s website, www.AHICsuccessor.org.


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HIPAA PREPARATION Article

Yes, it really is time to prepare for the next round of HIPAA. Support of a standard format for subrogation. A new version of a standard that includes the new business requirements that had to be put into "creative" uses of text and fields, clarifications that are no longer editorial, and segment and field usages more clearly defined - these are all part of the industry request to move the standards forward since the first round of HIPAA. NCPDP has updated the HIPAA page of the website to provide guidance documents and links. If you know someone not as up to speed on the next round of HIPAA, send them this email to provide them with summary information. Have you read the Notice of Proposed Rule Making (NPRM) for the HIPAA Transactions? The NPRM for ICD-10? Submitted your comments? (The deadline is October 21, 2008.) Have you read the implementation white paper from NCPDP SNIP? Are you participating in SNIP? Are you building your business plan for HIPAA?


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PRIVACY GUIDANCE ISSUED BY HHS OCR Article

On September 18, 2008, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published new guidance for complying with aspects of the HIPAA privacy rule. The guidance documents (consumers) and (providers) address when a provider may share a patient's health information with the patient's family, friends, or others involved in the patient's care.


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NCPDP STANDARDS NAMED IN HIPAA Article

The HIPAA Regulations Are Here!

The Department of Health and Human Services today announced the publication of the Notices of Proposed Rule Making (NPRMs) in the Federal Register for the next round of HIPAA.


The regulations will be published in the Federal Register on August 22, 2008. Companies are encouraged review the regulations and send in their comments. Remember to cite when you agree with a point, as well as offering suggestions when you disagree.

The standards to be named: NCPDP Strategic National Implementation Process (SNIP) Committee will coordinate the NCPDP response to the NPRMs. They will solicit comments from the work groups who have subject matter expertise, such as WG1 Telecommunication, WG9 Government Programs, WG14 Long Term Care, and WG45 External Standards Assessment, Harmonization, and Implementation Guidance.


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AHIC SEEKS PUBLIC COMMENTS Article

Between March of 2006 and March of 2008, the American Health Information Community (AHIC) published use cases. In April of 2008, the AHIC began the process of identifying 2009 priorities to serve as focus areas for standards harmonization and other national HIT agenda activities. During the June 2008 and July 2008 AHIC meetings, there was approval for development of one new "Use Case" and thirteen "Extensions/Gaps". The documents approved by AHIC for development include (* - denotes that this document will be a Use Case):
  1. General Laboratory Orders
  2. Order Sets
  3. Clinical Encounter Notes
  4. Medication Gaps
  5. Common Device Connectivity
  6. Scheduling
  7. Consumer Preferences
  8. Common Data Transport
  9. Newborn Screening*
  10. Medical Home: Co-Morbidity & Registries
  11. Maternal & Child Health
  12. Long Term Care - Assessment
  13. Consumer AE Reporting
  14. Prior-Authorization in Support of Treatment, Payment, & Operations
The first five documents, also referred to as "set 1" (General Laboratory Orders, Order Sets, Clinical Encounter Notes, Medication Gaps, and Common Device Connectivity) have been drafted by the Office of the National Coordinator for Health Information Technology (ONC) to represent the AHIC priorities and provide context for the national agenda activities, beginning with the selection of harmonized standards by the Health Information Technology Standards Panel (HITSP). Components that need to be considered during the standards identification and harmonization activities include standardized datasets, data elements, vocabularies, naming conventions, capabilities, and technical standards that support the information needs and processes.

These five documents, along with instructions for providing public feedback; are available for download. The webpage can be accessed by cutting and pasting the following link into your browser: www.hhs.gov/healthit/usecases/.

There will be one opportunity for review and feedback by interested stakeholders within both the private and public sectors. This public feedback period will last approximately four weeks and will close on September 12, 2008. The feedback will be analyzed, dispositional, and will be utilized in the development of the final documents.


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NCPDP PAYER SHEET TEMPLATE Article

In anticipation of the move to the Telecommunication Standard Implementation Guide Version D.0 as the next HIPAA-named version for pharmacy claims, the NCPDP SNIP Committee developed guidance to be used in filling out and creating payer sheets based on Version D.0 and above. Payer Sheets may be used in addition to provider manuals, or included in provider manuals. Payers may take the request and response template sections within the guidance document, fill out the template per their usage, and send to their trading partners. The guidance also provides instructional sections to assist the payers in completing their payer sheets. Click here for a copy.


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X12 RESPONDS TO NPRM Article

In response to the federal government's anticipated 2008 Notice of Proposed Rule Making (NPRM), expected to name 005010 replacements to the existing 004010A1 HIPAA mandate, X12 has launched a new website for the sale of these 005010 counterparts: http://store.x12.org

As a supplement to the guides, X12 is presenting a live webinar series that details the business justification for recommended solutions included in version 005010. Visit www.X12.org/webinars for details and to register.

The twelve transactions embodied in nine documents are now available for immediate PDF download, PDF shipped on a CD, or shipped as a bound document: The Implementation Guides, known as Technical Reports Type 3 (TR3s), may be purchased individually or as a suite for a modest price at www.X12.org. Once a Final Rule is published, pricing is subject to change and may include a discount for X12 members.


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RULES PROPOSED FOR CLAIM PAYMENT REMITTANCE Article

Pursuant to Minnesota Statutes, section 62J.536, rules have been proposed for the Minnesota Uniform Companion Guide for the Implementation of the Healthcare Claim Payment Remittance Advice Electronic Transaction (ASC X12 835). The proposed rules ( http://www.health.state.mn.us/asa/mn835compguide072808.pdf) are now available for public review and comment (http://www.health.state.mn.us/asa/rules.html ) The public comment period is July 28 - August 26, 2008.

NCPDP's WG45 External Standards Assessment, Harmonization, and Implementation Guidance is analyzing the situation and will discuss during the August Work Group meetings. Please review these materials.


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MINNESOTA UNIFORM COMPANION GUIDES Article

In an effort to assist with outreach and communication, NCPDP has created a website page with information and links on the Minnesota Uniform Companion Guides activities underway. Please note that the statute the work is based on applies to all purchasers (payers) and providers doing business in the state of Minnesota, not just those participating in Minnesota Medicaid. Transactions affected include NCPDP Telecom 5.1 (claim, reversal), ASC X12 270/271, 835, and 837.

The AUC, and specifically, the Claims Data Definition Technical Advisory Group (TAG) is charged with the following: "To create and develop common standards in cases where Medicare does not meet Minnesota needs and Minnesota commercial health plan group purchasers require providers to submit the 837 professional, 837 institutional, 837 dental and NCPDP 5.1 pharmacy claims differently, depending upon the group purchaser. An overarching principle of this work is the fact that, each MN group purchaser and provider will be required to make changes to procedures, policies and/or systems in some way, as a result of the work of the AUC and the Claims Data Definition TAG." (emphasis added)

See http://www.ncpdp.org/members/members_government_state.asp.


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NCVHS RECOMMENDS EPRESCRIBING CHANGES FOR LONG TERM CARE Article

Based on testimony from the industry, the National Committee on Vital and Health Statistics submitted a recommendation letter to the Secretary of HHS requesting eprescribing updates, especially for long term care use.

Recommendation 1:
Once NCPDP SCRIPT Version 10.5 is balloted and approved, NCVHS recommends that it be considered for voluntary adoption under the streamlined process for backward compatible standards. This would provide the functionality needed in long-term care settings to communicate information about prescription drugs that have been dispensed to a patient among facility, physician, and pharmacy and would provide direction to vendors developing e-prescribing products for long-term care. It would also allow for the voluntary use of the most recent version of the SCRIPT standard in ambulatory settings.

Recommendation 2: NCVHS also recommends lifting the current exemption from the requirement to use the NCPDP SCRIPT standard for non-prescribing providers in long-term care settings. The exemption currently applies to prescribers when they are required by law to issue a prescription for a patient to a non-prescribing provider (such as a nursing facility) that in turn forwards it to a dispenser. While long-term care facilities would be able to voluntarily use the NCPDP SCRIPT 10.5 standard even while the exemption is in place, we believe lifting the exemption sends a clear message to the industry about the desirability of e-prescribing in long-term care.

The letter is available at http://www.ncvhs.hhs.gov/


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EPRESCRIBING MANDATED IN MINNESOTA Article

Tim Pawlenty, Governor of Minnesota, recently signed legislation that mandates use of ePrescribing systems. As well, the new law further requires that all electronic health records systems implemented have CCHIT-certification.

The law requires that electronic prescribing be implemented by the beginning of 2011. Both medication dispensers and prescribers muse incorporate systems that utilize the National Council for Prescription Drug Programs' SCRIPT standard or Health Level Seven (HL7) messaging standards. These standards support transmission of prescriptions and related necessary information.

The new law, the 2008 Minnesota Health Care Reform Act or Senate File 3780, includes other provisions intended to increase both the availability and coverage of health insurance, reform the processes for payment, and increase the transparency of quality and pricing data. Additional components include improvements for the management of chronic care and funding programs to combat obesity and use of tobacco products.

Use of electronic health records are not mandated in the legislation passed. The requirement for CCHIT certification will ensure that various systems implemented across the state will be interoperable. Those systems must also be able to support ePrescribing.

Click Here for more information.


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NEXT ROUND OF HIPAA TRANSACTIONS - ARE YOU READY? Article

The NCPDP Strategic National Implementation Process (SNIP) has created an important white paper to assist the industry in preparing for the next round of HIPAA-named transactions. It's time to get started! For information, go to http://www.ncpdp.org/news_hipaa_snip.asp.


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NCPDP LAUNCHES DATAQ, A NEXT GEN PHARMACY DATABASE RESOURCE PROVIDING REAL-TIME ACCESS AND CUSTOMIZED REPORTING Article

SCOTTSDALE, Ariz. - April 23, 2008 - The National Council for Prescription Drug Programs (NCPDP), today announced the launch of dataQ™, a next generation pharmacy data solution that provides healthcare stakeholders with the most up-to-date and in-depth pharmacy information available. dataQ enables pharmacies, PBMs, health plans and other stakeholders improved pharmacy database accuracy and streamlined electronic claims processing for faster reimbursement of prescription drug claims. It is also used for pharmacy network development and credentialing, data validation, drug utilization monitoring and product recalls, along with market research and analysis.

Available with varying subscription and administrative levels, the new resource expands functionality to include optional real-time web access to pharmacy data, extensive custom reporting and file download capabilities. dataQ's industry-leading accuracy and integrity is based NCPDP's on deep data validation, verification and documentation processes, which have been trusted for decades. The launch reflects a natural evolution of the Standard Pharmacy Database v2.1 product containing almost 75,000 pharmacies, which will continue to be available. Originally developed to provide NCPDP Provider ID enumeration, the unique identifier for pharmacies, it now contains the new National Provider Identifier (NPI) on pharmacies and has grown to be the industry's most comprehensive database of consistently updated pharmacy information.

"Using a time-tested method of assigning "intelligent" identification codes to data fields, dataQ provides more than just raw data; it is a way to identify, sort and categorize that data in a nimble manner previously unavailable in the industry," stated NCPDP President LeeAnn Stember. "It is an invaluable data tool for payers and other drug claims processors, pharmacies, pharmaceutical and biotech manufacturers, informatics companies, pharmacy practice management system vendors, list procurement vendors and more. The new solution will allow pharmacies to have more access and control over their own information, with the ability to update their data via any web-based browser and view their data in a real-time environment."

Added Stember, "With the new real-time look-up option for subscribers, we anticipate that dataQ will become an indispensable troubleshooting tool that empowers healthcare organizations to enhance productivity, reduce costs and improve the bottom line."


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UPDATED VERSION 5 EDITORIAL DOCUMENT PUBLISHED Article

The "Telecommunication Version 5 Questions, Answers, and Editorial Updates" is available on the NCPDP website on the HIPAA public or members only WG1 Telecommunication page. The document has been updated with information from CMS on the use of the Prescription Origin Code (419-DJ) in the future, which was discussed during WG1 Telecommunication in May. See the appendix of changes for the specific section (click here).


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NCPDP BYLAWS AND STANDING OPERATING PROCEDURES APPROVED Article

During the General Business Session of NCPDP's Annual Conference May 4-8, 2008, the updated NCPDP Bylaws and Standing Operating Procedures were approved by the membership. These documents have now been posted on the NCPDP website. Go to the dropdown menu in the About Us section.


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CMS RELEASES PART D E-PRESCRIBING FINAL RULE Article

CMS released the Part D electronic prescribing final rule today, establishing Part D e prescribing standards for four types of information. The standards adopted under the rule will apply to all Part D sponsors, as well as to prescribers and dispensers that electronically transmit prescriptions and prescription-related information about Part D covered drugs prescribed for Part D eligible individuals. The rule adopts four standards for use in e-prescribing:
The new Part D e prescribing standards, which will be effective on April 1, 2009, supplement a set of "foundation" standards which took effect with the start of Part D on January 1, 2006. For more information, please see the CMS Press Release or visit the CMS E-Prescribing website, where the final rule on Part D e prescribing standards (CMS-0016-F/CMS-0018-F) and the earlier final rule establishing e prescribing foundation standards (CMS-0011-F) will be available.


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NCPDP PROVIDES MEDICAID AGENCIES WITH HCIDEA™ PRESCRIBER DATABASE - WAIVES LICENSE FEE Article

Scottsdale, AZ - After careful consideration and in an effort to streamline the transition from legacy prescriber identifiers to the NPI on the HIPAA named NCPDP Telecommunication Standard for pharmacy claims, the National Council for Prescription Drug Programs (NCPDP) has announced that it is waiving the annual license fee on its HCIdea™ Prescriber Database product for all Medicaid agencies.

The HCIdea™ product is a relational database containing prescriber DEA numbers, state licenses, NPIs, multiple addresses and other prescriber information. It obtains prescriber NPIs from the CMS National Plan and Provider Enumeration System (NPPES) only, the supplier of prescriber NPIs and primary data source. Providing NPPES data in a format useful for those processing Medicaid prescription drug claims solves a nagging problem for the prescription drug benefit industry which in many cases has been unable to obtain the correct NPI for prescribers.

The database will be provided free of charge for one year, with monthly updates. The offer is available immediately upon the signing of a subscription license. In return, Medicaid agencies agree to provide NCPDP through its technical partner, Ingenix, Inc. with a simple file of prescriber Medicaid IDs so that NCPDP may complete the NPI to Medicaid ID crosswalk needed for some agencies.

A not-for-profit ANSI-accredited standards development organization, NCPDP's mission is to provide standards to the pharmacy services sector. Part of that mission is to provide a "source of truth" for prescriber NPIs to ease the transition for pharmacies and other stakeholders involved in the prescription drug benefit.

The HCIdea™ database was built specifically to solve the prescriber identifier problem that exists for the pharmacy services sector. Pharmacies and PBMs do not usually have business relationships with prescribers and utilizing the NPPES downloadable database effectively, requires significant technical expertise. NCPDP engaged Ingenix, Inc. in 2006 to aid in this effort.

Using HCIdea™ insures that Medicaid agencies: For more information, contact Robin Ebert at rebert@ncpdp.org or call 480-477-1000, ext. 118.


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NCPDP PUBLISHES LONG-TERM CARE REBATE REPORTING GUIDANCE Article

NCPDP has announced publication of an update to the guidance for reporting of rebates entitled Long-Term Care (LTC) Rebate Reporting Guide for Medicare Part D, developed by the WG14 Long Term Care Pharmacy Rebate Task Group in collaboration with Centers for Medicare and Medicaid Services (CMS). This document provides guidance for LTC pharmacies in reporting rebates to Part D sponsors or Pharmacy Benefit Managers representing Part D sponsors, and identifies inherent limitations in both the scope and the use of the data. The document was modified at the request of CMS to address a technical error in the original LTC Rebate file layout. The modification changed the field definition from numeric to text for information, such as NPI, in which leading zeroes must be maintained. This document is available on the NCPDP website at
http://www.ncpdp.org/news_feds.asp#rebate.


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NCVHS RECOMMENDS STANDARDS MOVE FORWARD UNDER HIPAA Article

On September 26, 2007, the National Committee on Vital and Health Statistics recommended to the Department of Health and Human Services that the following transactions be moved through the Notice of Proposed Rule Making (NPRM) processes. NCVHS also recommended items on timing of implementation, various methods of testing, and outreach to stakeholders.

Please see www.ncvhs.hhs.gov for the full recommendation letter.


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