Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Adoption Level	Federally required	Cost	Test Tool Availability
Implementation Specification	NCPDP® Formulary and Benefit Standard Version 3.0	Final	Production		Yes	$	No
Implementation Specification	NCPDP Real Time Prescription Benefit Standard Version 12	Final	Production		No	$	No
Implementation Specification	NCPDP Formulary and Benefits (F&B), Version 60	Final	Production	Feedback Requested	No	$	No
Implementation Specification	NCPDP Real-Time Prescription Benefit (RTPB) Standard, Implementation Guide, Version 13	Final	Feedback requested	Feedback Requested	No		No

Limitations, Dependencies, and Preconditions for Consideration	Applicable Security Patterns for Consideration
Feedback requested.	Secure Communication – Create a secure channel for client-to- serve and server-to-server communication. Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery. Authentication Enforcer – Centralized authentication processes. Authorization Enforcer – Specifies access control policies. Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos). Assertion Builder – Define processing logic for identity, authorization and attribute statements. User Role – Identifies the role asserted by the individual initiating the transaction. Purpose of Use - Identifies the purpose for the transaction.

Limitations, Dependencies, and Preconditions for Consideration

Applicable Security Patterns for Consideration

Feedback requested.

Secure Communication – Create a secure channel for client-to- serve and server-to-server communication.
Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery.
Authentication Enforcer – Centralized authentication processes.
Authorization Enforcer – Specifies access control policies.
Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos).
Assertion Builder – Define processing logic for identity, authorization and attribute statements.
User Role – Identifies the role asserted by the individual initiating the transaction.
Purpose of Use - Identifies the purpose for the transaction.

Comment

Submitted by pwilson@ncpdp.org on 2023-10-06

NCPDP Comment

NCPDP recommends that ONC remove NCPDP Formulary and Benefit Standard Version(s) 53, 54 and 55.
NCPDP recommends that ONC remove the comment, “The NCPDP® WG18 Patient Consent task group is working on a solution for the exchange of patient consent information between providers,” from the Limitations, Dependencies and Preconditions for Consideration section. The WG18 Patient Consent Task Group has been disbanded.

Submitted by shellyspiro on 2023-10-02

Pharmacy HIT Collaborative (PHIT) comment

PHIT supports NCPDP’s recommendation to remove NCPDP Formulary and Benefit Standard Version(s) 53, 54, and 55.

Submitted by pwilson@ncpdp.org on 2022-09-30

NCPDP Comments

NCPDP recommends updating – NCPDP Formulary and Benefit Standard Version 53 to the following:

NCPDP Formulary and Benefit Standard Version 60

Submitted by pwilson@ncpdp.org on 2021-09-29

NCPDP Comments

For NCPDP Real-Time Prescriptions Benefit Standard, add “Version 12” to the Standard/Implementation Specification title.

Submitted by pwilson@ncpdp.org on 2020-11-07

NCPDP Comment

Remove existing NCPDP verbiage under “Limitations”.
Add the following:

Type-Implementation Specification

Standard Implementation/Specification- NCPDP Formulary and Benefit Standard, Implementation Guide, Version 53

Standards Process Maturity – Final

Implementation Maturity – Feedback requested

Adoption Level – Feedback requested

Federally required – No

Cost - $

Test Tool Availability – No

Modify the following:

Type-Implementation Specification

Standard Implementation/Specification- NCPDP Real Time Prescription Benefit Standard

Standards Process Maturity – Final

Implementation Maturity – Production

Adoption Level – 1

Submitted by pwilson@ncpdp.org on 2019-09-23

NCPDP Comment

NCPDP developed a Beta version of the Real Time Prescription Benefit Standard to be balloted in the Fall of 2019.

Submitted by mattreid on 2019-09-23

Real Time Prescription Benefit

The American Medical Association appreciates the opportunity to comment. Real-time Prescription Benefit (RTPB) is mentioned, however it is not linked nor actually named. We believe this section should be updated as RTPB now has a standard out for ballot.

Submitted by pwilson@ncpdp.org on 2017-11-20

NCPDP - Comment

The second bullet under Limitations, Dependencies, and Preconditions for Consideration should be modified to the following:
- NCPDP is developing a Real Time Prescription Benefit standard that should be monitored as a potential emerging implementation specification.