The purpose of this bulletin is to inform workers' compensation system participants of various issues with the National Council for Prescription Drug Programs (NCPDP) Universal Claim Form (UCF).
In December 2006, the Division adopted amendments to 28 TAC §133.10(b) extending the NCPDP UCF implementation date from January 1, 2007 to January 1, 2008 . This amendment was adopted for the purpose of making the NCPDP UCF implementation date consistent with the eBilling implementation date and to give system participants a longer period of time to integrate the NCPDP UCF into their processes. Recently, system participants have provided the Division with numerous concerns and comments regarding technical, financial, and process issues which impede the successful implementation of the NCPDP UCF by January 1, 2008 . These system participants support the continued use of the Division's DWC-66 (Statement of Pharmacy Services) until such time as the NCPDP formally adopts a universal claim form that is tailored to the workers' compensation system. In order to maintain continuity of services for injured employees, pharmacies may continue, beyond January 1, 2008 , to submit their claims for pharmacy services by using the Division's DWC-66. System participants should work together to ensure that necessary health care is appropriately delivered.
The Division anticipates that the NCPDP will in the future consider and adopt a universal claim form that is tailored to the workers' compensation system. However, as a result of these comments and the lack of a NCPDP form that is suitable for the workers' compensation system, the Division will initiate rulemaking efforts to amend 28 TAC §133.10(b) to address these concerns. The Division expects to file proposed amendments to 28 TAC §133.10(b) with the Texas Register in January 2008 and to proceed with adopting appropriate amendments no later than the first quarter of 2008.
If there are any questions regarding the information in this bulletin, please contact Allen McDonald, Director of Information Management Services, at 512-804-4530 or email at Allen.McDonald@tdi.state.tx.us.
Commissioner of Workers' Compensation
Texas Department of Insurance