November 08, 2011 08:38 ET

NCPDP Takes On the Evolving Needs of ePrior Authorizations

ePA Task Group Reconvenes to Explore, Automate and Standardize the Paper-Based, Time-Intensive Process of Coordinating Prior Approval on Certain Drugs and Procedures

SCOTTSDALE, AZ--(Marketwire - Nov 8, 2011) - The National Council for Prescription Drug Programs (NCPDP), the leading not-for-profit pharmacy standards development organization, announced today the launch of its latest initiative to bring its collaborative, consensus-based process to bear on the electronic coordination of prior authorizations (ePA) when required for drugs and procedures.

The prior authorization (PA) process is a time-consuming, costly and cumbersome healthcare issue that often delays a patient from getting needed medications. Physicians and their office staff, pharmacists, payers and patients are impacted by the hours to days-long process that may require multiple phone calls and faxes, and coordination using the patient's benefit plan to identify the drug-specific, paper-based PA form before it can be evaluated by the payer or health plan. The inefficiencies plague all stakeholders in the process, as the industry as a whole looks for solutions to reduce costs and deliver higher quality healthcare services.

Collaboration in Action
Utilizing its proven, collaborative, consensus-based process, NCPDP convened a focus group on ePA in October 2011. Participants included representatives from every healthcare industry stakeholder group involved in the process of requesting, coordinating, reviewing and fulfilling or dispensing drugs and procedures that require prior approval from payers and insurers. The goals of the focus group were to evaluate use of existing ePA transactions and pilot efforts underway, and assess industry needs for ePA that have expanded with advances in medication therapy management (MTM), biotechnology, designer drugs and other factors.

ePA Task Group
Based on the outcomes of the ePA Focus Group, NCPDP will reconvene its ePA Task Group to take the information from the focus group and standardize ePA transactions. While the focus of the ePA Task Group will be on medications, the group will also consider workflow of medical PA to develop a flexible standard for the exchange of data.

"The process of coordinating prior authorization for medications causes great angst for physicians and their office staff, pharmacists, payers, and the patients themselves," explained Lee Ann Stember, President of NCPDP. "We will move this initiative forward through the ePA Task Group, with the active participation and support of industry stakeholders who have fueled NCPDP's leadership in the transformation and automation of the pharmacy industry for over 30 years."

For more information on the ePA Task Group or to participate in a future meeting via teleconference, contact

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 services include the NCPDP Provider Identification Number, a unique identifier of over 75,000 pharmacies, and HCIdea, "The Prescriber Identity Solution." 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