Medicare Program; Secure Electronic Prior Authorization For Medicare Part D
medicare · Centers for Medicare and Medicaid Services · Rule · Published 2020-12-31 · Effective 2021-02-01 · 85 FR 86824
Document
Document number
2020-28877
Federal Register citation
85 FR 86824
CFR reference
42 CFR 423
Type
Rule
Action
Final rule.
Category
medicare
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2020-12-31
Effective date
2021-02-01
HHS docket
CMS-4189-F
Abstract
This final rule names a new transaction standard for the Medicare Prescription Drug Benefit program's (Part D) e-prescribing program as required by the "Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act" or the "SUPPORT Act." Under the SUPPORT Act, the Secretary is required to adopt standards for the Part D e-prescribing program to ensure secure electronic prior authorization request and response transmissions. In this final rule, we amend the Part D e- prescribing regulations to require Part D plan sponsors' support of version 2017071 of the National Council for Prescription Drug Programs (NCPDP) SCRIPT standard for use in certain electronic Prior Authorization (ePA) transactions with prescribers regarding Part D- covered drugs to Part D-eligible individuals.