July 22, 2013 07:57 ET

NCPDP Announces Availability of Standardized Transactions for ePA in SCRIPT Standard

Electronic Prior Authorization Transactions Give Physicians and Other Prescribers Access to Information on Covered Medications at the Point of Care; Standardized Process for Industry-Wide Adoption Automates the Time-Intensive and Paper-Based Process of Coordinating Prior Approval on Certain Drugs

SCOTTSDALE, AZ--(Marketwired - Jul 22, 2013) -  The National Council for Prescription Drug Programs (NCPDP) announced today the approval and availability of electronic prior authorization (ePA) transactions within the NCPDP SCRIPT Standard for ePrescribing. "This achievement demonstrates our collaborative process in action," explained Lee Ann Stember, President of NCPDP, "bringing healthcare stakeholders together to develop standardized transactions for ePA that will enable the healthcare industry to exchange prior authorization requirements for medications as part of the doctor-patient encounter." The ePA transactions are available in the SCRIPT Standard, which was named in the Medicare Modernization Act (MMA) and is a requirement of Meaningful Use (MU).

When used with an eligibility inquiry and the formulary and benefit file exchange, the ePA transactions enhance the electronic prescribing workflow to assist in more complete information exchange between the prescriber and the patient to identify the appropriate medication based on the patient's benefit plan. This provides "clean" prescriptions to the pharmacy.

The NCPDP prior authorization transactions are intended to be used for products covered by a patient's pharmacy benefit (e.g. medications and supplies). The prior authorization transactions:

  • Provide a fully electronic means for determining whether prior authorization is required for a particular medication and particular patient.
  • 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 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. 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, 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," said Stember.

The NCPDP SCRIPT Standard version 2013071 is available with NCPDP membership. See

Founded in 1977, NCPDP is a not-for-profit, ANSI-accredited, Standards Development Organization with over 1,600 members representing virtually every sector of the pharmacy services industry. Our diverse membership provides leadership and healthcare business solutions through education and standards, created using the consensus building process. NCPDP has been named in federal legislation, including HIPAA, MMA, and HITECH. NCPDP members have created standards such as the Telecommunication Standard and Batch Standard, the SCRIPT Standard for e-Prescribing, the Manufacturers Rebate Standard and more to improve communication within the pharmacy industry. Our data products include dataQ®, a robust database of information on more than 76,000 pharmacies, and HCIdea®, a database of continually updated information on more than 2.3 million prescribers. NCPDP's RxReconn® is a legislative tracking product for real-time monitoring of pharmacy-related state and national legislative and regulatory activity. For more information about NCPDP Standards, Data Services, Products, Educational Programs and Work Group meetings, go online at or call (480) 477-1000.

Contact Information

    Janet Cabibbo
    Amendola Communications for NCPDP
    480-664-8412 ext. 15
    Email Contact