Welcome to Our New Member Orientation!
Joint Technical Work Group Meetings | November 2019
What is NCPDP?
NCPDP is an American National Standards Institute (ANSI) accredited standards development organization (SDO).
NCPDP provides a forum and marketplace for a diverse membership focused on healthcare and pharmacy business solutions to move interoperability forward.
NCPDP is a member-driven organization that has been named in various government regulations and policies (including HIPAA and Medicare Modernization Act).
VISION
Lead the industry in healthcare standards and solutions for the common good.
PURPOSE
To standardize the exchange of healthcare information to improve outcomes.
CORE VALUES
CollaborationInclusiveness
Integrity & Ethical BehaviorLeadership Innovation
VISION PURPOSEO
BJE
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IVE
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9-
20
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WHY IT MATTERS GOAL
UPI powered by Experian Health UIM and NCPDP Standards™
Improves patient matching to support preventable medical errors as the #3 killer in the U.S.
Work with regulatory agencies to increase trading partners awareness of patient safety through UPI/Patient Matching product offering and identify key connections to specialty pharmacy and PDMP solutions.
Specialty Pharmacy Standards Enhancements
Creating a focal point around Specialty at NCPDP will drive action to automate and standardize specialty prescribing and pharmacy related transactions to speed therapy to patients.
Expand specialty membership while focusing on outcomes/solutions for patients to advance better adherence.
Real-Time Benefit Transaction
Increases automation in workflow to decrease administration burden and cost to healthcare ecosystem; and improves patient engagement, adherence and outcomes.
Increase industry awareness of NCPDP’s role in transforming healthcare and expand NCPDP’s ability to create solutionsthroughout the healthcare industry.
NCPDP Standards-based facilitator Model for PDMP, An Interoperable framework
NCPDP’s approach prevents diversion, ensures appropriate access and protect patients.
Continue EDvocacy efforts in promoting NCPDP’s Standards-based Facilitators Model for PDMP to combat national opioid crisis.
BRAND PURPOSE BRAND PROMISE BRAND ESSENTIALS
Lead the industry in healthcare standards and
solutions for the common good.
To standardize the exchange of healthcare information to improve outcomes.
Focus on thePatient
In Work-Flow to support Interoperability
Relevance Standards-Based
Patient Safety
NCPDP Membership
1,700 Members
NCPDP Standards & Healthcare Experience
NCPDP’s Standards Development Process
• Getting the right people in the room, engendering trust• Consensus-based process, solutions• Driven by business need, patient safety• Workflow-enabled solutions
Standards Development Process
Requests for new standards or modifications to existing standards, data elements or values:
Data Element Request Form
(DERF)Data maintenance ballots are open
to NCPDP members and
persons directly and materially affected by the
ballot
Voting Consensus Group is formed
annually
• Approved DERFs requesting a new standard or modifications to existing standards are balloted.
• Approved DERFs requesting a change to the External Code List (ECL) are not balloted. The ECL is updated and published quarterly.
• NCPDP members and interested parties must register each year to participate.
• The Consensus Group is expected to vote on all new ballots and follow those ballots through completion.
Change to Standards
Changes to Data Elements, Values, Implementation
Guides
Project Development for
NCPDP
Assignment of Proper Billing Units
• Data Element Request Form (DERF)• Changes done through balanced ballot process• Valid Ballot = 60% of Consensus Group must return their ballot• Ballot approved or adopted = must receive 75% approval rate of the affirmative votes and negative votes with reasons • ONE Person = ONE Vote
• New Project Development Form
• Billing Unit Request (Quantity Unit Information Communication [QUIC] Forms)
MCMaintenance & Control
Work Groups
WG 1Telecommunication
WG 2Product Identification
WG 7Manufacturer &
Associated Trading Partner Transaction Standards
WG 9Government Programs
WG 10Professional Pharmacy
Services
WG 11ePrescribing & Related
Transactions
WG 14Long Term & Post Acute Care
WG 16Property & Casualty/Workers’
Compensation
WG 45External Standards Assessment, Harmonization &
Implementation Guidance
WG 18Specialty Pharmacy
Information on each work group is available at http://www.ncpdp.org/Standards-Development/Work-Group-Listing
Work Group Experience
• Co-Chairs facilitate • Staff Liaison proves support• Ballot actions and TG
Reports• Standards, Implementation
Guides, Data Dictionary, External Code List discussion
• White Paper & Guidance Document review
• Current Issues & Topics
• Parliamentary meeting protocol (Robert’s Rules)
• Issues that impact published documentation require approval by the attendees
• Speakers must be identified by co-chair
• Microphones are provided for capturing minutes
• Cell phone protocol maintained (song/dance/joke)
For more information on how Work Groups Function, Access NCPDP University from your member portal
Your Member Portal
How Do You Get Involved?
• Go to the Get Involved page on http://www.ncpdp.org/Membership/Get-Involved.aspx .
• Review minutes and documents before attending work group meetings.▪ Bring documents to work group meeting for reference.
• Read the NCPDP Now electronic newsletter.
• Talk with your Buddy about opportunities that match your interests.
• Speak Out – Take an active role in the meetings.
• Join a Task Group, Work Group or Committee.
VOTE! This is your opportunity to have a direct impact on the standards development process.
NCPDP Collaborative Workspace
• Participants must agree to abide by NCPDP expected conduct.
• The NCPDP Collaborative Workspace contains ▪ Announcements
▪ Calendar
▪ Working documents – by work group/task group/date of call
▪ Help
• If the task group is in your profile, you will receive subsequent meeting invites and emails. If you wish to join a call of interest, see the Collaborative Calendar and add the entry to your personal calendar.
Opportunity for Professional Growth
• Gain broad industry perspective on issues.
• Learn formal consensus process.
• Learn to facilitate discussions.
• Practice conflict resolution.
• Improve public speaking skills.
• Represent stakeholder group interests.
• Gain group leadership experience.
• Improve strategic thinking skills.
Good for your career!
NCPDP Provides Support Programs
• Buddy Program▪ One-on-one help with WG participation and networking
• New Member Luncheon▪ Overall orientation to NCPDP
• NCPDP University ▪ Online library of presentations – how to make the most of
membership
• Brown Bag Sessions▪ Offered quarterly at WGs
• Emerging Professionals Group ▪ Networking events to get connected
• Webinars▪ Education about industry issues and NCPDP solutions
• Commitment • Communication• Collaboration• Coaching• Leadership
• Confidence• Industry Experience • Time Management • Trustworthy
COMPETENCIES
• Analytical Thinker • Knowledgeable • Project Management Skills• Communication Skills• Collaborative Team Builder• Forward Thinking • Strategic Thinking • Leadership Skill
COMPETENCIES
• Leadership Skills• Collaboration • Budgeting/Fiscal Responsibility • Industry Knowledge• Strategic Thinking• Engagement• Commitment
COMPETENCIES
Member Awards
MVP Award
Rising Star Award
Benjamin D. Ward Distinguished
Member Award
TIME Award
Recognizes valuable, active participation at the work group and committee levels.
Recognizes a new member for active participation within the first three years of joining the organization.
Recognizes outstanding achievement, consistent dedication and/or exemplary leadership of a member over time. Named after the founding member of NCPDP.
The Individual Member Excellence Award honors a member for unselfish devotion toward meeting the goals and objectives of NCPDP.
Table Discussion – 20 minutes
NCPDP Certification Program
• Provides members and qualifying non-members an opportunity to obtain a distinguished certification based on the ability to demonstrate knowledge and understanding of implementing NCPDP Standards accurately and effectively.
▪ NCPDP SCRIPT V2017071 Exam• 115 questions (multiple choice, T/F, multiple selection) & completed
within 90 minutes
▪ Delivery Methods: • NCPDP Proctored Exam (in-person exam held during Joint Quarterly
Work Group Meetings)• Online Proctored Exam (anytime, anywhere)• Kryterion Testing Centers (all across the US)
▪ Contact: Brian Goerlich, Certification Program Manager, via email at [email protected] or visit: http://ncpdp.org/Education/Certification-Program
NCPDP Products & ServicesQuality data and information that
simplifies and improves the way you do business.
Accurate prescriber data that is continually updated using patented auto-verification technology, providing an authoritative source for NPI, address, and DEA number relationships.
Industry’s single source-of-truth for capturing and sharing standardized, self-reported pharmacy credentialing data.
This vendor-neutral solution from NCPDP and Experian Health addresses the complexities of managing patient identification across the health care ecosystem.
Real-time monitoring of healthcare-related state and federal legislation and regulatory activity.
Data on more than 80,000 pharmacies and non-pharmacy dispensing sites nationwide.
501(c)(3) nonprofit charitable organization established in December 2012 to support:
• Better healthcare through standards-based health information technology for the common good.
• Standards-based health information technology has the potential to make healthcare for you and your family safer and more effective. It transforms the way your care providers communicate with one another and with you to manage your health.
• http://ncpdpfoundation.org/
NCPDP Matching Funds
Donations to NCPDP Foundation, a 501(c)(3) non-profit organization, are tax deductible to the extent allowed by law.
A receipt for your donation will be sent to you for tax purposes. Tax I.D. No. EIN 46-2161880
www.NCPDPFoundation.org
Annual Conference and Educational Summit
• Annual Technology & Business Conference
▪ Multi-day opportunity to network and make connections.
▪ Learn about industry trends and what is on the horizon.
▪ Multiple opportunities to meet with business partners –“getting business done.”
▪ Exposure to emerging technologies and industry leaders.
▪ Educational Summit▪ One-day program
o Update on the latest NCPDP solutions to critical industry challenges.
o Help to stay ahead of ever-changing rules, regulations
and standards.
Meeting Information and Registration
• How do I get information about NCPDP work group meetings, educational programs, and webinars?
▪ NCPDP website
▪ NCPDP Now electronic newsletter
▪ Program brochures
▪ Member emails
• Register for WG meetings and education events from your member portal.
Communication for Members
• NCPDP Now, News Flash, and other email campaigns (members only)
• NCPDP Collaborative Workspace
• Update on strategic initiatives at work group meetings
• Annual report
• Event/product marketing
• Annual Meeting of the Membership
• Collateral materials
• Industry meetings and exhibits
• Media relations
Introduction of 2019-2020 BOT Members
Gregory S. Kaupp, J.D., MPA, MLTKaupp Advisors
Payer/Processor
William J. Barre, R.Ph.CitizensRx, LLC
Gregory Watanabe, R.Ph., MBAIndependent Consultant
Introduction of 2019-2020 BOT Members
Producer/Provider
Alan K. Gardner, MBARxResults, LLC
Michele Vilaret Davidson, R.Ph., NSCWalgreen Co.
Christian Tadrus, R.Ph., Pharm.D., FASCP, NSC
Independent Pharmacist
Introduction of 2019-2020 BOT Members
Vendor/General Interest
Perry LewisExactCarePharmacy
Chair
Mark Gingrich, M.S. Surescripts
NCPDP Leaders
Lee Ann StemberPresidentand CEO
John W. Hill, MBAHCM, CNEDExecutive Vice President
and GM
Executive Management
John Klimek, R.Ph.Senior Vice President,
Standards and Information Technology
Steve Mullenix, R.Ph.Senior Vice President,
Public Policy andIndustry Relations
Phillip D. ScottSenior Vice President, Business Development
Maggie BruceSenior Vice President,Strategic Planning and
Communications
Standards Development Staff
Mar
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• WG1
Kit
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• WG7
• WG9
Pat
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Pau
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• WG 16• WG 45Technical Analyst
Terr
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• WG 18• WG 2• MC
Tere
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Senior Manager
• WG11• WG14ModelFacilitator
Vice President Standards Development
Director & VP Level Staff
Jan Marie Mayo Director,
Product Developmentand Database Services
Margaret WeikerVice President,
Standards Development
Janet CabibboDirector,
Communicationsand Marketing
Senior Level Staff
Sandy KovalikSenior Manager,
FinanceAdministration
Rick ReedSenior Manager,
Pharmacy DatabaseServices
Senior Level Staff (continued)
Nicole RussellSenior Manager,
Government Affairs
Jeremy ViethSenior Manager,
Information Technology and Facility
Sherri TeilleSenior Manager,
Product Marketingand Sales Operations
Managers
Kim Dixon-Williams, CMP Manager,
Meeting Planning
Brian GoerlichManager,
Certification Program
Vincent FinocchiaroManager,
Membership Services
Mia RicciNational Account
Executive
Thank you and welcome to NCPDP!
The First Time Attendee survey will be distributed by email next week. Please complete the survey. Your
opinions are important!
Appendix - Standards and Implementation Guides
• Telecommunication Standard
• REMS Reference Guide
• Post Adjudication Standard
• Prior Authorization Transfer Standard
• Financial Information Reporting Standard
• Uniform Healthcare Payer Data Standard
• Retiree Drug Subsidy Standard
• Manual Claim Form Reference Guide (for the Universal Claim Form [UCF])
• Audit Transaction Standard
WG1
Telecommunication
• Billing Unit Standard
• Product Identifiers Standard
WG2
Product Identification
Appendix - Standards and Implementation Guides (continued)
• Manufacturer Rebates Standard
• Medical Rebates Data Submission Standard
WG7
Manufacturer and Associated Trading Partner Transaction
Standards
• Batch Standard
• Medicaid Subrogation Implementation Guide
WG9
Government Programs
WG10
Professional Pharmacy Services
• Specialized Implementation Guide
• Structured and Codified Sig Format
Appendix - Standards and Implementation Guides (continued)
• SCRIPT Standard
• Formulary and Benefit Standard
• Prescription File Transfer Standard
• EHR-S Standalone Electronic Prescribing Functional Profile and the Pharmacy/ Pharmacist Provider Functional Profile
• Standalone Electronic Prescription EHR-S Functional Profile
WG11
ePrescribing and Related Transactions
• Workers’ Compensation Universal Claim Form
WG16
Property and Casualty/Workers’
Compensation
Appendix - Standards and Implementation Guides(continued)
• This is a newly formed work group.WG18
Specialty Pharmacy
• Data Dictionary
• External Code List (ECL)
• Operating Rules for Connectivity
MC Maintenance and Control