HHS shares an update on the Modifications to the National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of Medicaid Subrogation Standard (CMS-0056-F) Interim Final Rule
The Department of Health and Human Services (HHS) is making interested parties aware of the National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards and the Medicaid Pharmacy Subrogation Standard Interim Final Rule (IFR) that displayed today, August 20, 2025, and will publish on August 21, 2025 in the Federal Register.
Specifically, this IFR updates compliance and other dates presented in the final rule that appeared in the December 13, 2024, Federal Register (89 FR 100763) titled “Administrative Simplification: Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of the Medicaid Pharmacy Subrogation Standard” (hereinafter referred to as the December 2024 final rule) and to conform with the subsequent correction notice that appeared in the February 11, 2025, Federal Register (90 FR 9289).
Background
A correction notice published on February 11, 2025, (90 FR 9289) (hereinafter known as the February 2025 notice) delayed the December 2024 final rule's effective date by 60 days to April 14, 2025. This delay was necessary to give agency officials the opportunity for further review and to take into consideration this new regulation, which is consistent with the Presidential memorandum of January 20, 2025, titled ‘‘Regulatory Freeze Pending Review.”
The February 2025 notice also acknowledged the impact of the delayed effective date on the compliance, and transition period dates for covered entities and state Medicaid agencies.
What Will This Interim Final Rule Do
This IFR establishes a new transition period and compliance dates for HIPAA covered entities that were previously adopted.
Summary of the Updated Compliance Dates:
Starting August 14, 2027, all covered entities, as agreed by trading partners, may use either Version D.0 and Version 1.2 or Version F6 and Version 15 for 8 months as a transition period prior to full compliance, which begins 36 months after the effective date of the final rule.
All covered entities must comply with Version F6 and Version 15 beginning April 14, 2028.
Starting August 14, 2027, State Medicaid agencies, as agreed to by trading partners, may use Version 3.0 or Version 10 for 8 months as a transition period before full compliance, which begins 36 months after the final rule's effective date.
State Medicaid agencies must comply with Version 10 beginning April 14, 2028.
