NDC COORDINATION AND IMPLEMENTATION FORUM
For Payers and PBMs
Your adjudication engine can pass every internal test and still reject claims from a partner you never checked.
FDA's 12-digit NDC format takes effect in 2033, and the current HIPAA reimbursement standard doesn't yet accommodate it, meaning your systems, your pharmacy network, and your manufacturer partners all need to move in sync. The NDC Forum is where payers and PBMs test readiness against the trading partners who actually feed their claims pipeline, with Strike Force access reserved for members.
The Challenge
Claims processing, formulary management, utilization management, reimbursement, and rebate administration all depend on NDC matching working correctly, every time, across every system that touches a claim. NDC-12 doesn't just affect one system. It affects the interconnected chain of systems that determine whether a claim adjudicates correctly, a rebate calculates accurately, and a formulary rule applies to the right product.
Adjudication logic depends on exact NDC matching; a mismatch is a rejected or misprocessed claim
Rebate and chargeback calculations depend on consistent product identification across manufacturer and processor systems you don't control
Dual-format operation creates real risk of formulary and utilization-management rules failing to apply correctly
The current HIPAA reimbursement standard doesn't yet accommodate NDC-12, so your systems will need to bridge a gap that isn't fully resolved yet
How the Forum Helps
Monitor trading-partner readiness across the pharmacy and provider network you depend on for clean claims.
Understand implementation timelines across the full ecosystem, not just the standards changes that affect you directly.
Participate in cross-sector planning discussions shaping the HIPAA-alignment and testing questions that determine when your systems can finalize their own approach.
Get early visibility into standards decisions instead of waiting for finalized guidance to react to.
Why This Isn't Just a Claims-System Upgrade
Your organization may already be working with an advisory firm on readiness, or leaning on NCPDP for standards guidance. Both are the right instincts, and neither one closes the gap that actually determines whether your claims run clean on day one.
A regulatory-compliance advisor can tell you whether your adjudication engine is technically capable of handling NDC-12. They can't tell you whether the pharmacies and manufacturers feeding your claims pipeline will be submitting clean, tested data on your timeline.
NCPDP and other standards bodies are essential to defining the rules your systems need to follow. They aren't built to operationally track whether your specific trading partners have tested against those rules yet.
The single biggest source of claim-processing risk in this transition isn't your system. It's the partner you have no visibility into.
The Forum is where payers, PBMs, manufacturers, pharmacies, and distributors test readiness against each other, not just against a specification.
You already know what a rebate reconciliation error costs. Strike Force participation, where HIPAA-alignment and testing questions actually get resolved, is member-only. A single forum visit tells you where the conversation stands; membership is what puts your organization inside it.
Get Involved
Organizational Membership
Annual Membership
$5,000
per organization
Unlimited participants from your organization
Access to all quarterly forums, strike forces, and other events
Full access to tools, outputs, and shared resources
Per-Participant Access
Virtual
Quarterly Forums
$399
per person
In-Person
Forums
TBD
per person
Attend quarterly forums on a per-person basis, ideal for organizations exploring participation before committing to full membership.
2026 Forum Dates:
September 23
December 8-9
Strike force participation available to organizational members only.