What you need to know

As Prime’s work to comply with National Council for Prescription Drug Programs (NCPDP) F6 requirements progresses, we are currently focused on assessing the changes needed across our adjudication platforms and planning for future execution. This work supports Prime’s broader strategy to modernize our applications while continuing to meet client and member needs. 

As part of this effort: 

• Prime is focused on ensuring FirstRx and Judi® claim adjudication platforms are compliant with NCPDP F6 requirements. 
  • Clients currently on RxCLAIM are scheduled to migrate to Judi ahead of the NCPDP F6 compliance date of April 14, 2028.   

Background 

The Centers for Medicare and Medicaid Services (CMS) issued a final rule (CMS-0056-F) on Dec. 13, 2024, outlining modifications to NCPDP retail pharmacy standards and Medicaid pharmacy subrogation standards. The changes impact data files, including eligibility files, claim files and related reporting. 

This communication serves as a follow-up to Prime’s December 2025 communication and provides an overview of current project status. The project remains on schedule to meet the final compliance date. 

Q1 2026 progress updates 

Prime continues to work closely with internal teams, partners and clients to finalize the business and system requirements for the adjudication platform and supporting downstream systems. Current work is focused in three primary areas: 

Systems integration inventories 

• Prime is reviewing and validating all data connections and file exchanges to ensure inventories are complete, accurate and up to date.
• This work helps identify gaps or needed changes to standard and client‑specific files for Prime and our clients to plan the path forward. 

 Stakeholder engagement 

• The project team and your account management team is reviewing all implementation‑readiness materials and communications impacted by the F6 project. 
• Client documentation and communications are being reviewed and refined to support a clear, well-coordinated implementation. 

Test strategy and implementation 

• A comprehensive testing plan is in development for the F6 transition, with testing expected to begin in early 2027 following internal preparation. 
• Following internal testing, Prime will work directly with each client and vendor to support collaborative testing, gather feedback, and reduce disruption. 

Next steps 

Prime will continue to keep clients informed as this initiative progresses. Clients can expect: 

• Quarterly updates on overall project status and milestones. 
• Supplemental communications as timelines, impacts or requirements are finalized. 
• Direct outreach for client-specific planning, data needs and testing when appropriate. 

Questions

Please reach out to your Prime account team representative.