The Centers for Medicare & Medicaid Services (CMS) released a Final Rule  mandating the use of the SCRIPT Standard Version 2023011, Real-Time Prescription Benefit (RTPB) Version 13 and Formulary and Benefit (F&B) Version 60 standards. These updates will further modernize electronic prescribing and enhance patient-specific benefit management. The benefits include:

1. Improved Prescription Accuracy and Efficiency

• The updated SCRIPT Standard Version 2023011 enhances electronic prescribing (ePrescribing) by allowing more precise communication between prescribers and pharmacies. This minimizes the risk of miscommunication, transcription errors, and delays in dispensing medications.

2. Enhanced Transparency for Patients and Providers

• Real-Time Prescription Benefit (RTPB) Version 13 enables healthcare providers to instantly access patient-specific benefit information, including the cost of medications, potential alternatives, and out-of-pocket expenses. This helps prescribers select the most cost-effective treatment options.
• Patients can see the real-time cost of medications and potential alternatives based on their insurance coverage, empowering them to make informed decisions with their providers.

3. Streamlined Prior Authorization Process

• These standards can improve and automate the prior authorization process by providing real-time updates about medication coverage and pre-approval requirements, reducing delays in treatment caused by manual prior authorization processes.

4. Better Formulary and Benefit Information

• Formulary and Benefit Version 60 improves the availability and accuracy of formulary data (i.e., lists of covered drugs under an insurance plan), enabling healthcare providers to more easily check which drugs are covered and at what tier. This reduces back-and-forth communication between pharmacies, providers, and insurance companies about medication coverage.

5. Cost Savings and Adherence to Therapy

• By allowing prescribers to choose lower-cost alternatives that are covered by insurance, these standards can reduce the financial burden on patients, potentially improving medication adherence and patient outcomes.
• Lowering administrative burdens (e.g., reducing rework and prescription errors) can result in cost savings for healthcare systems.

6. Interoperability and Integration Across Platforms

• These standards promote better integration across different healthcare IT systems (e.g., EHRs, pharmacy systems, and payer systems), improving data sharing and interoperability between stakeholders. This streamlines processes and reduces administrative burdens for healthcare providers.

7. Compliance with Federal Regulations

• The adoption of these updated standards ensures compliance with federal regulations, minimizing the risk of penalties for non-compliance and positioning healthcare providers to meet future regulatory requirements.

8. Support for Innovation

• These standards lay the groundwork for future enhancements in health IT, such as more advanced decision support systems and real-time analytics to improve prescribing practices and overall healthcare delivery.

The timelines published for entities to comply  with the rule are as follows:

• SCRIPT v2017071 or SCRIPT v2023011 may be used until Jan 1, 2028, after this date only SCRIPT 2023011 may be used.
• Formulary & Benefit v3 or v60 may be used until Jan 1, 2027, after this date only v60 must be used.
• RTPB v13 must be used by Jan 1, 2027

Logisolve’s Health Science Solution Team is positioned to provide support to your organization during the NCPDP SCRIPT upgrade (The National Council for Prescription Drug Programs’ electronic prescription standard) by offering expertise and strategic guidance through the technical, compliance, and operational aspects of the upgrade to ensure your organization meets  the regulatory timeline in the following ways.

1. Assessment of Current Systems and Gap Analysis

• Evaluate Existing Systems: Logisolve can assess your company’s current e-prescribing systems and identify gaps or deficiencies in meeting the new NCPDP SCRIPT standards (e.g., moving from SCRIPT 10.6 to SCRIPT 2017071).
• Compatibility Review: Analyze whether current software or workflows are compatible with the new standards and what needs to be upgraded or replaced.
• Compliance Gap Analysis: Identify areas where your company is non-compliant with the latest regulatory requirements and recommend necessary changes.

2. Development of an Upgrade Roadmap

• Project Planning:  Logisolve can work with your organization and teams to create detailed, phased roadmap that includes timelines, resource requirements, and budget estimates.
• Stakeholder Management: Work closely with internal teams (IT, legal, compliance, pharmacy teams) to ensure alignment and smooth communication across departments.

3. Technical Implementation and Integration

• Software Development & Integration: If custom development or third-party software integration is required, Logisolve can provide technical expertise to implement the upgrade.
• Testing and Validation:  Run extensive tests, including unit testing, integration testing, and user acceptance testing (UAT), to ensure the upgraded system functions as expected.
• Interface Updates: Update interfaces between your company’s systems and external partners (e.g., pharmacies, prescribers, and PBMs) to meet the new standard.

4. Regulatory and Compliance Guidance

• Ensure Compliance:  Logisolve can help your company comply with federal and state regulations tied to NCPDP SCRIPT standards, ensuring the upgrade adheres to the latest mandates from CMS, DEA, and other relevant regulatory bodies.
• Documentation: Assist in documenting compliance efforts and system upgrades to satisfy future audits or regulatory inquiries.

5. Training and Change Management

• User Training: Provide training programs to educate employees on the new system functionalities and workflows post-upgrade.
• Change Management: Implement change management strategies to ensure staff are comfortable with the transition and any new processes or tools.

6. Post-Implementation Support and Monitoring

• Go-Live Support: Offer on-site or remote support during the “go-live” period to address any issues that arise after the upgrade is completed.
• Ongoing Monitoring: Monitor system performance post-implementation, ensuring everything operates efficiently and in compliance with the new SCRIPT standards.
• Continuous Optimization: Suggest further optimizations or improvements based on system performance and feedback.

7. Vendor Coordination

• Collaboration with Vendors: If external vendors are involved (e.g., e-prescribing platform providers, EHR vendors), Logisolve has  established strong  and trusted relationships with vendors that we lean into to help facilitate communication and coordination to ensure a smooth upgrade process.

8. Risk Management and Contingency Planning

• Risk Assessment: Identify potential risks (e.g., system downtime, data integrity issues) and develop contingency plans.
• Backup and Recovery: Ensure that backup systems are in place to prevent data loss or service interruptions during the upgrade.

9. Cost Management

• Budgeting and Cost Control: Help your organization manage costs associated with the upgrade, ensuring the project stays within budget while minimizing unnecessary expenses.

The Health Science Solutions Team at Logisolve is excited to help support new and existing clients through these changes as they enhance their systems and comply with federal mandates. 

For more information, reach out to Rob.Mohr@Logisolve.com  or Melissa.Brown@Logisolve.com  to discuss how  our team can offer both technical and strategic expertise to streamline the NCPDP SCRIPT upgrade process, while ensuring compliance, operational efficiency, and minimal disruption to your organization’s e-prescribing workflows.

 Additional References:

Centers for Medicare & Medicaid Services 42 CFR Part 423 Office of the Secretary 45 CFR Part 170 [CMS-4205-F2] RIN 0938-AV24 Medicare Program; Medicare Prescription Drug Benefit Program; Health Information Technology Standards and Implementation Specifications2024-12842.pdf

 Standards – Home (ncpdp.org)