HealthIT Answers April 11, 2021
Through recent statute and regulations, the Congress and federal government have finally given recognition to two standards from the National Council on Prescription Drug Standards (NCPDP) for use by the industry. One standard for electronic prior authorization (ePA) was specifically named in a regulation from the Centers for Medicare and Medicaid Services (CMS) for use in Medicare Part D. This was required under the 21st Century Cures Act. The Consolidated Appropriations Act of 2020 (which funded the federal government for fiscal year 2021) calls for Health and Human Services (HHS) to adopt a real-time pharmacy benefit (RTPB) standard. Although the law does not name the NCPDP RTPB standard as the one to be used, the text of this section of...
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