RxCUI
Question:
Because more than one Drug (NDC) is tied to a given RXCUI, our drug.json file we are generating could include the same RXCUI several times with different drug names along with different indicators for prior authorization, step therapy, and quantity limits. This doesn’t seem to present any problems with the validator – will it cause issues for the consumers?Answer:
You can duplicate the RxCUI entries to display the multiple entries and properly reflect the covered drugs. Our primary concern is to show the user that their drug is covered in some form under their plan.Question:
For QHPs that submit SERFF format files, the drug data is tied to a specific point in time. I have not seen any indication that this will be the case for the data in the drugs.json file. Is it assumed it will always use the most current drug data for generating the RxCUI ID?Answer:
The RxCUI ID in the machine-readable file will be the current ID when the formulary data was updated by the issuer.___________________________________________________________________________________