NCPDP and CAQH CORE to harmonize electronic data interchange

The National Council for Prescription Drug Programs (NCPDP) and the Committee on Operating Rules for Information Exchange (CAQH CORE) have agreed to collaborate on activities related to harmonizing electronic data interchange standards and operating rules across the healthcare industry.

NCPDP and CAQH CORE began exploring the potential partnership in late 2010 when the National Committee on Vital Health Statistics (NCVHS) recommended NCPDP be formally named as an operating rules entity for retail pharmacy-related eligibility transactions and CAQH CORE serve as the authoring entity for operating rules for non-retail pharmacy-related eligibility and claim status transactions.

The NCVHS recommendations were made to the Department of Health and Human Services in response to the Patient Protection and Affordable Care Act administrative simplification requirements which mandate national operating rules. Recent recommendations by NCVHS for CAQH CORE to develop operating rules for electronic funds transfer and electronic remittance advice have furthered the collaborative efforts between CAQH CORE and NCPDP.

NCPDP, the Scottsdale, Ariz.-based ANSI-accredited standards development organization for pharmacy, has led the automation of pharmacy through standards development for over 30 years; and CORE, a multi-stakeholder initiative created by CAQH, located in Washington, D.C., develops and maintains operating rules to make administrative information available at the point of medical care.

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