Surescripts Certification Policy and Compliance
Compliance has always been an integral part of Surescripts’ work and the value we bring to the e-prescribing industry. The Surescripts Certification Policy and Compliance function is dedicated to formalizing and centralizing compliance and certification requirements management for all Participants (Technology Vendors, PBM/Payers, and Pharmacies) on the Surescripts network.
The Certification Policy and Compliance team works to validate that all connected Participants implement and certify against a standard set of requirements. Once certified, the team monitors the Participants to make sure all Participants remain in compliance with the standard set of requirements. Our goal is efficiency and consistency across the network, so all Participants can meet the highest measures of patient safety, end-to-end reliability, and electronic prescription quality.
By adhering to the approved Surescripts certification requirements, Participants are assured they are in compliance with transaction standards, Surescripts network requirements, and Surescripts connectivity requirements. Adherence also enables Participants to send quality electronic prescriptions across the network.
What principles serve as the basis of the Surescripts Certification Policy and Compliance function?
The Certification Policy and Compliance function is focused on the following core foundational and guiding principles:
Objectivity – as defined by the following Foundational Principles:
2. Efficiency of the end-to-end Surescripts network.
3. Cost effectiveness of the Surescripts network.
Neutrality – requirements that are based on furthering e-prescribing as a whole versus some groups having undue influence.
Transparency – requirements are published and provided to Participants during implementation; Participants can view the requirements process.
Auditability - requirements are based on testable events.
Legality – requirements are aligned with government mandates related to e-prescribing functionality.
How does the Surescripts certification policy help Participants?
Our Certification process gets Participants successfully connected to the Surescripts network by:
Being efficient and thorough.
Meeting the needs of the entire Surescripts connected community
Aiding our Participants’ readiness to participate in government programs such as HITECH, MMA, Part D, and MIPPA.
Adhering to the Foundational and Guiding Principles
Once Participants are connected to the Surescripts network, our goal is that all Participants remain connected for everyone’s benefit. The Surescripts Certification Policy focuses on patient safety, efficiency and reliability on the network, and aids in our Participants continued participation in government incentive programs.
By holding all Participants equally accountable for meeting certification requirements, our Participants can send and receive the highest quality electronic prescriptions and e-prescribing continues to progress overall as in industry.
What are the Surescripts Certification requirements based on?
The Surescripts Certification Requirements are created based on the following:
Surescripts network requirements.
Transaction standards organizations: ANSI ASC X12, HL7, and NCPDP
Surescripts connectivity requirements
The Certification Policy Foundational and Guiding Principles
When creating and updating the requirements, Surescripts receives input from our connected Participant stakeholders across the industry and reviews all submitted certification requirement requests. We strive to implement certification requirements that meet the needs of all Participant types, are consistent with our Foundational and Guiding principles, and drive e-prescribing process efficiency. We solicit feedback from our Participants via Surescripts workshops and participant surveys.
How does the Compliance function impact Participants?
The Surescripts Certification Policy and Compliance team performs regularly scheduled and ad hoc compliance checks as needed for all Participants on the Surescripts network. The team utilizes defined compliance review processes and distributes standard communications. If any compliance issues are identified, we work with Participants to develop remediation plans to address the issues as quickly and efficiency as possible.
Components of the compliance check function include:
Execution of compliance checks.
Creation of Participant compliance reports.
Out of compliance notifications based on error trending.
Development of remediation plans.
Distribution of Participant Certificates of Compliance
Execution of the decertification process and removal from the Surescripts network based on a Participant’s failure to meet a remediation plan
Execution of a Participant’s reinstatement on the Surescripts network when all compliance requirements are met
By working together, all e-prescribing Participants can continue to provide the highest quality standards and products for all patients, prescribers, and pharmacies using the Surescripts network.
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