MC Maintenance and Control monitors and maintains the development of NCPDP standards, implementation guides and reference documents, promotes consistent business and technical administration, makes recommendations to the Standardization Co-Chairs on development procedures, due process compliance, as well as ethical and legal matters. MC provides a forum for updates of work group activities, resolution of inter-Work Group issues and discussion of legislative, regulatory, policy, and court decisions which may affect the pharmacy industry.
WG9 Government Programs Goals
- Promote NCPDP membership attendance and active participation in work group meetings and task groups.
- Provide a forum for members to discuss new federal and state policies and procedures as they relate to the practice of pharmacy and the NCPDP Standards, which may include but are not limited to:
- Medicare Programs (e.g., Medicare Part A, Part B, Part C, Part D, Hospice, End Stage Renal Disease),
- Medicaid and Children’s Health Insurance Program,
- Medicare-Medicaid Plan (MMP) and other dual eligible programs,
- Federal and state-Funded programs (e.g., State Pharmaceutical Assistance Program, Ryan White/AIDS Drug Assistance Program, 340B),
- Federal and state Health Insurance Marketplaces, and
- Cost and reimbursement basis for government programs (e.g., Actual Acquisition Cost (AAC), Usual & Customary (U&C), Wholesale Acquisition Cost (WAC), National Average Drug Acquisition Cost (NADAC), Average Manufacturer Price (AMP), Federal Upper Limit (FUL)).
- Promote and provide support for the use of NCPDP Standards for government programs whether regulated, mandated, or through voluntary industry adoption.
- Review and recommend changes to implementation of the standards development process and regulatory process as related to government programs.
- Collaborate with government agencies to develop and maintain Frequently Asked Questions (FAQs) and Best Practices documents to support the implementation of government programs and associated regulations.
- Maintain the Medicaid Subrogation Implementation Guide for Batch Standard, Prescription Drug Monitoring Programs Reporting Standard and Financial Information Reporting Standard.
- Monitor and track the State Prescription Drug Monitoring Programs.
- Collaborate with Prescription Drug Monitoring programs in identifying and implementing streamlined, innovative and viable electronic solutions.
- Collaborate with the National Medicaid EDI HIPAA Workgroup (NMEH) on issues related to State Medicaid programs.
- Monitor WG9 task groups to ensure they are tracking scope, goals, and deliverables. Disband task groups that have completed their work.
- Support the MC Maintenance and Control Education-Legislation and Regulation Task Group when new legislation is being introduced regarding issues relevant to the work group.
- Collaborate with other NCPDP work groups and Strategic National Implementation Process (SNIP) Committee as needed.
- Review Data Element Request Forms (DERFs) and adjudicate ballots pertaining to standards within the scope of this work group.
- Analyze, develop and execute Webinar opportunities for WG9 in coordination with Educational Programs Advisors Group.
For a list of acronyms, please see the Acronym Dictionary
WG9 Government Programs Scope
- Work Group 9 Government Programs, in conjunction with Work Group 1 Telecommunication and other Work Groups, as necessary, guides and advises federal and state pharmacy programs and their agents on NCPDP standards. WG9 also supports data processing initiatives, and provides design alternatives for standards, which support government requirements.