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NCPDP's SCRIPT now supports electronic prior authorization
July 22nd, 2013
SCOTTSDALE, Ariz. – The National Council for Prescription Drug Programs (NCPDP) announced the approval and availability of electronic prior authorization (ePA) transactions for its SCRIPT standard for electronic prescribing.
NCPDP said Monday that ePA transactions provide standardized process that automates the time-consuming, paper-based process of coordinating prior approval on certain drugs, giving doctors and other prescribers access to information on covered medications at the point of care.
When used with an eligibility inquiry and the formulary and benefit file exchange, NCPDP explained, the ePA transactions enhance the e-prescribing workflow by enabling more complete information exchange between prescribers and patients to identify the proper medication based on the patient benefit plan — providing "clean" prescriptions to the pharmacy.
"This achievement demonstrates our collaborative process in action, bringing health care stakeholders together to develop standardized transactions for ePA that will enable the health care industry to exchange prior authorization requirements for medications as part of the doctor-patient encounter," NCPDP president Lee Ann Stember said in a statement.
The NCPDP prior authorization transactions are for products covered by a patient's pharmacy benefit, such as medications and supplies. These transactions provide a fully electronic means for determining if prior authorization is need for a particular medication and a particular patient, NCPDP said, and they present prior authorization information needs to the prescriber in a consistent format while enabling each payer to request the particular information it requires.
The ePA transactions are available in the SCRIPT standard, which was named in the Medicare Modernization Act and is a requirement of meaningful use.
NCPDP added that the ePA transactions use a model of a specific standardized structure that supports questions that can be customized based on the patient and the medication being requested. The question and answer logic and structure are standardized to support a consistent approach, and the transactions support the use of clinical attachments, such as subsets of the medical record, which can improve the prescriber's workflow by reducing the amount of information that must be entered.
"By building the ePA transactions into the SCRIPT standard," Stember stated, "we are making it easier for prescribers to have access to ePA functionality within the federally mandated industry standard and improving patient access to needed medications."