Work Group 1 Telecommunication develops and maintains standards and guidelines to accommodate the collection, transmission, and processing of information that may be exchanged electronically or in written formats. The information exchanged may be used for, but is not strictly limited to, such purposes as administering and certifying eligibility, establishing prior authorization for products and services, pharmacy claim billing, payment determination, denial of compensation with explanations, drug use review, determination of benefits and the exchange of adjudicated data between business associates.
Work Group 2 Product Identification deals with issues relating to the identification of drugs and health related products within NCPDP’s stated mission. Identification consists of how the product is billed (billing units,package size designations), product identification systems, and any type of descriptive data which serves to uniquely identify a product with the intent to establish standards for product identification such that there is no ambiguity in distinguishing one product from another.
Work Group 7 Manufacturer and Associated Trading Partner Transaction Standards develops, monitors, and maintains standards for the electronic exchange of data amongst manufacturers and trading partners to facilitate business processes. Additionally, the work group promotes implementation and education of the standards.
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.
Work Group 10 Professional Pharmacy Services supports the pharmacist’s individual and collaborative planning, delivery, documentation and quality assessment of patient care services through the development and distribution of standards, standards-based templates, and implementation guides. These documents/tools in conjunction with the publication of best practices recommendations encourage patient engagement, foster patient safety and support consistent delivery of patient care services to optimize outcomes.
WG10 strives to support pharmacists in utilizing their unique training and expertise to provide patient care services related to the appropriate use of medications. Patient care services are provided in many different practice settings and include activities such as medication therapy management, clinical reconciliation (medication, allergies and problems), patient immunization management, disease state monitoring, adverse drug event reporting and therapy adherence program management. Pharmacists contribute to improving patients’ health by providing patient care services as authorized by license and allowed under their scope of practice and collaborative practice agreements.
WG18 Specialty Pharmacy Goals
For a list of acronyms, please see the Acronym Dictionary
- Promote NCPDP membership attendance and active participation in work group meetings and task groups.
- Identify pain points and transactions that delay the prescribing, dispensing, care management, reporting, and payment of specialty medications and determine if an existing electronic transaction and/or standard can be used or enhanced to improve the process.
- Develop new standardized transactions and messages for prescribers, pharmacists, payers, manufacturers and other interested parties in exchanging information related to specialty prescriptions (e.g., enrollment, reporting).
- Develop guidance regarding the use of existing standards and transactions to improve Specialty related processes.
- Monitor state and Federal activities and legislation related to specialty medications and specialty prescribing.
- Collaborate with other Standards Development Organizations (SDOs) and other industry organizations to ensure streamlined and innovative exchange of information related to specialty prescriptions.
- Collaborate with other NCPDP Work Groups and Task Groups as their work or tasks impact specialty medication transactions (e.g., ePA, REMS and ePrescribing).
- Drive increased participation in the following membership categories:
- Pharmaceutical Manufacturers
- Software Vendors
- Specialty and Compounding Pharmacies
- Ancillary service providers, such as hubs and infusion centers
- Care Providers, such as health systems, long term care, and home care
- Accreditation bodies
- Monitor WG18 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.
- Review Data Element Request Forms (DERFs) and adjudicate ballots pertaining to standards for which this work group is responsible.
- Analyze, develop and execute education opportunities for WG18 standards and guidance in coordination with the Educational Programs Advisors Group.
WG18 Specialty Pharmacy Scope
- Develops, monitors and maintains existing and new standards and guidance for the electronic exchange of data amongst providers, pharmacies, manufacturers, payers/processors and other stakeholders to facilitate patient access to specialty products and related business processes.
The work group, in conjunction with other NCPDP Work Groups, guides and advises stakeholders on standards implementation and supports data processing initiatives. The work group may request modifications to other NCPDP standards as necessary.