The Council For Affordable Quality Healthcare's Committee on Operating Rules for Information Exchange (CAQH CORE) will collaborate with the National Council for Prescription Drug Programs (NCPDP) on activities related to harmonizing electronic data interchange standards and operating rules across healthcare.
NCPDP and CAQH CORE began exploring the partnership 2010 when the National Committee on Vital and Health Statistics (NCVHS) recommended that NCPDP be formally named as an operating rules entity for retail pharmacy-related eligibility transactions, and that CAQH CORE serve as the authoring entity for operating rules for non-retail pharmacy-related eligibility and claim status transactions.
[See also: CAQH makes new recommendations for CORE governance.]
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 (EFT) and electronic remittance advice (ERA) have furthered the collaborative efforts between CAQH CORE and NCPDP.
[See also: CAQH, Edifecs launch platform for certifying CORE conformance.]
"Through standards development and harmonization, we will continue to break down healthcare information technology barriers and improve the cost and quality of care for the patient," said NCPDP President Lee Ann Stember. "We are pleased to collaborate with CAQH CORE on orchestrating operating rules and standards to improve the coordination and delivery of healthcare."
"CAQH CORE and NCPDP share a mutual commitment to industry collaboration and consensus building processes that focuses on actionable change," added Gwendolyn Lohse, deputy director and CORE managing director at CAQH. "Aligning our intersecting efforts will help advance widespread industry adoption of effective and productive healthcare exchanges."
Both organizations are foundational to the healthcare information exchange process: NCPDP, the 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, develops and maintains operating rules to make administrative information available at the point of medical care.