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.
MC Maintenance and Control 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.
- Continue participation in and collaboration with Designated Standards Maintenance Organization (DSMO) Change Request System (CRS) process.
- Continue collaboration with Health Level Seven International (HL7®), X12 Incorporated, Workgroup for Electronic Data Interchange (WEDI), Council for Affordable Quality Healthcare (CAQH) Committee on Operating Rules for Information Exchange (CORE) and other external organizations.
- Review New Project Development requests and make recommendations to the Standardization Co-Chairs.
- Review and recommend changes to the implementation of standards development and regulatory processes, such as those related to the Health Insurance Portability and Accountability Act (HIPAA), the Medicare Modernization Act (MMA), the Health Information Technology for Economic and Clinical Health (HITECH) Act, the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA).
- Continue to maintain the Data Dictionary, External Code List (ECL) and Emergency ECL Addendum.
- Monitor MC task groups to ensure they are tracking scope, goals, and deliverables. Disband task groups that have completed their work.
- Review and adjudicate all Data Element Request Forms (DERFs).
- Analyze, develop and execute Webinar opportunities for MC in coordination with Educational Programs Advisors Group.
- Resolve conflicts identified by staff in the Definitions, Entities, and Workflow documents.
MC Maintenance and Control Scope
- 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.