Pharmacist Services Technical Advisory Coalition
Operating Guidelines
History
The Pharmacist Services Technical Advisory Coalition (the Coalition) was established to improve the coding infrastructure necessary to support billing for pharmacists’ professional services. Coalition activities include updating electronic data interchange standards, modifying coding structures, and supporting provider identifiers.
The Coalition was formed in April 2002 following the February 2002 release of the HIPAA compliant X12N 837 Health Care Claim: Pharmacy Professional Services Companion Guide an Electronic Data Interchange subset of the ASC X12N 837 Health Care Claim Implementation Guide: Professional. The guide provides the unique standardized electronic data and format requirements (EDI transaction segments) that are equivalent to submitting a health care encounter/claim for professional services submitted by pharmacists and pharmacies on the paper CMS Form 1500. The Coalition, originally organized as the X12 Pharmacy Advisory Panel, was formed to address the use of the X12N 837 format for such billing.
Following development of the Coalition, the National Community Pharmacists Association (NCPA) sought collaboration from other pharmacy organizations supportive of advancing professional services billing using the X12N 837 platform and willing to assist in building the infrastructure necessary to bill for services, including providing oversight for the X12N 837 Health Care Claim: Pharmacy Professional Services Companion Guide. Initially, the American Pharmacists Association (APhA) and the American Society of Consultant Pharmacists (ASCP) joined the Coalition. Since then, the American College of Clinical Pharmacy (ACCP), American Society of Health-System Pharmacists (ASHP), and the Academy of Managed Care Pharmacy (AMCP) have become Coalition members.
Membership
Coalition Members
The coalition comprises pharmacy organizations supportive of advancing professional services billing using the X12N 837 platform and willing to assist in building the infrastructure necessary to bill for services. Any addition of organizations to the Coalition is subject to approval by a simple majority of Coalition Members.
Steering Committee
Coalition activities are guided by a group of individual pharmacists comprising the Steering Committee. Each Coalition Member is allowed three (3) appointees to the Steering Committee. The initial term of the members will be a two (2), three (3), and four (4) year term with each Coalition Member designating which of their appointees will serve each term. After the initial terms have expired, all subsequent terms will be for a period of three (3) years. This allows for a one-third (1/3) turnover in membership every year after the initial two (2) years. Each Steering Committee member shall support the policies and objectives of the Coalition, provide leadership, and report to the Coalition on affairs relevant to the objectives of the Coalition. If a Steering Committee member wishes to resign prior to completion of his/her term, that pharmacist’s appointing organization will name a replacement to fulfill the duration of the term.
Operation and Administration
Coalition expenses, net of revenue generated by coalition activity, will be divided equally among participating organizations. All administrative and meeting expenses shall be equally shared by each Coalition Member organization, according to a pre-approved budget and invoiced in timely manner. Any material changes to this budget will be approved in advance by the Coalition Members. Each respective organization is responsible for all representative Steering Committee travel expenses.
The administrative office of the Coalition shall reside at NCPA. Administrative support for the Steering Committee shall be provided by Coalition Member staff liaisons, in collaboration with NCPA staff.
Meetings
The Steering Committee shall meet at least annually. Additional meetings may be called by the Chair and agreed upon by the Steering Committee.
Quorum and Terms of Office
A quorum of the Coalition shall be a majority of the members. If a quorum fails to attend a meeting, those attending may recess the meeting from time to time until a quorum is attained and shall conduct the meeting when reconvened in accordance with the call of the meeting. Terms of office shall begin on July 1st.
Steering Committee Voting Process
Each Coalition Member is entitled to a maximum of three (3) votes [one (1) vote for every Steering Committee member present]. In the event that a vote is required, a 75% or greater majority is required for approval, thereby encouraging a unified voice.
Officers and Staff
The officers of the Steering Committee shall be a Chair elected by the Steering Committee members and they shall serve for an initial two (2) year term followed by a one (1) year term or until a successor is elected. The Chair shall preside at all meetings of the Steering Committee and shall perform such other duties as may from time to time be requested. An Executive Secretary shall serve as the chief executive of the Coalition and shall have general supervision over the business and operation of the Coalition, subject to the control of the Chief Executive Officers of the Coalition Members.
Coalition Representatives
Representatives of the Coalition to external groups shall be elected from among current Steering Committee members by a simple majority of Coalition Members.
Ownership
The Coalition shall copyright and own all work products, including standards documents and specifications. The information content of these items shall be in the public domain, be actively promoted for use by any interested party, and be provided to any party upon payment of nominal charges established by the Coalition. The copyrights shall be established to assure control of the accuracy of published standards document and specification materials although they shall not prevent Coalition-granted authority for accurate reproduction and further dissemination of those materials, in part or in full, by Coalition members, to promote those standards use.
Modifications to the Operating Guidelines
Recommendations for modifications to the operations of the Coalition shall be submitted as agenda items at least 120 days in advance for consideration at the next Coalition Member staff meeting. Any change to the Operating Guidelines is subject to a vote by Coalition Members.
Termination and Dissolution
A request to terminate the Coalition may occur at any time from a Coalition Member. Each Coalition Member will be notified in writing of the request to terminate within thirty (30) days. The Coalition Members would then convene a meeting within one-hundred twenty (120) days. If the termination vote is approved by a simple majority of Coalition Members, the Coalition will terminate without further discussion. All assets and debt will be divided among the former Coalition Members.