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Emerging NCPDP Standard Enhancements to Improve Speed to Therapy for Specialty Medications
By Pooja Babbrah, Practice Lead, PBM Services Specialty medications are changing health care, providing life-saving treatment options for patients with rare and chronic conditions. Patients, however, often face big hurdles …
CDS Hooks Are Win-Win-Win for Providers, Patients and Health IT Vendors
By Michael Burger, EDI Practice Lead CDS Hooks are a new SMART on FHIR technology that will enable providers to receive timely information about individual patients, their condition and potential …
Diving Deeper into CMS’ Proposed Rule on Electronic Prior Authorization for Medicare Part D Drugs
By Jocelyn Keegan, Payer Practice Lead, and Ken Kleinberg, Innovative Technologies Practice Lead The Center for Medicare and Medicaid Services (CMS) recently announced a proposed rule that would require use …
Emerging NCPDP Standard Enhancements to Improve Speed to Therapy for Specialty Medications
By Pooja Babbrah, Practice Lead, PBM Services Specialty medications are changing health care, providing life-saving treatment options for patients with rare and chronic conditions. Patients, however, often face big hurdles …
Well-Intentioned CAQH Releases PA Operating Rules for Disappointing X12 278
By Ken Kleinberg, Practice Lead, Innovative Technologies CAQH’s (Council for Affordable Quality Healthcare) recently released their new Phase V CORE Operating Rules for prior authorization (PA) that improve on specificity …
CARIN Alliance Workgroup to Help Advance Real-Time Pharmacy Benefit Check for Patients
By Pooja Babbrah, Practice Lead, PBM Services The CARIN Alliance—a large, multi-stakeholder coalition–has formed a workgroup aimed at advancing the consumer-facing, real-time pharmacy benefit check (RTPBC). The goal is to …
Urgent Need for Real-Time Pharmacy Benefit Check Confirmed in Senate Committee Hearings
By Pooja Babbrah, PBM Services Practice Lead In mid-March, I was invited to testify in front of the U.S. Senate Special Committee on Aging at a hearing they held focused …
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