What you need to know

Prime’s work to modernize our applications to better align with evolving healthcare industry needs and comply with the National Council for Prescription Drug Programs (NCPDP) F6 requirements continues.  

Prime remains focused on ensuring the FirstRx and Judi claim adjudication platforms are compliant with NCPDP F6 requirements. Current RxCLAIM clients will migrate to Judi ahead of the NCPDP F6 compliance date of April 14, 2028.  

The project remains on schedule to meet the final compliance date.  

Background 

The Centers for Medicare and Medicaid Services (CMS) issued a final rule (CMS-0056-F) on Dec. 13, 2024, mandating an industry-wide transition of NCPDP standards from version D.0 to version F6 by April 14, 2028. 

This communication serves as a follow-up to Prime’s Q1 NCPDP F6 update and provides an overview of current project status.  

Q2 2026 progress updates 

Prime's overall project progress is positive, with focus on core adjudication updates to support the F6 changes. Phased releases will continue through the end of the year as we shift focus from building to execution, testing and client readiness. Below are a few key progress updates that outline the current project priorities: 

Testing, readiness and enablement 

• Test strategy planning is in progress.  
• Efforts to identify all data exchange points – inbound, outbound and extracts is in progress. 
• Scenario planning for regression and User Acceptance Testing (UAT) to validate functionality and support readiness is ongoing. 
• Test case development is progressing to enable continued phased delivery. 
• Prime is creating and reviewing inventory of impacted documentation and training materials.  

Cross-functional workstreams 

• Supporting business areas (Finance, Reporting, Data, Clinical) are in planning or early analysis phases across the FirstRx and Judi platforms, with work focused on downstream impacts and requirements. 
• Judi governance cadence has been established, with requirement walkthroughs underway to advance planning. 

What's coming in Q3 

• Finalization of upstream data changes.  
• Completion and alignment of detailed requirements across teams. 
• Continued coordination across interdependent workstreams to maintain timelines. 
• Evaluation of potential external vendor impact to align timelines and testing. 

Next steps 

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

• Details of changes necessary to support receiving NCPDP F6 claims files that clients will need to update. 
• Supplemental communications as timelines, impacts or requirements are finalized. 
• Direct outreach for client-specific planning, data needs and testing when appropriate. 

Questions

Reach out to your Prime account team representative.