Washington, D.C. Oct. 17, 2006 –URAC called for public comment today on the first-ever proposed accreditation standards for pharmacy benefit management organizations. The goal of the program is to create a pharmacy benefit management accreditation program for the commercial and Medicare markets that promotes industry best practices; encourages quality improvement; and protects and empowers consumers. URAC is seeking comments from a broad range of stakeholders, including employers, consumers, purchasers, providers, regulators, and the pharmacy benefits management industry. The deadline for public comment is December 1, 2006.

“Accreditation sets industry-wide clinical and operational standards and brings a recognizable seal of quality to accredited organizations,” said Alan P. Spielman, URAC’s president and chief executive officer. “URAC’s goal in developing accreditation standards is not to dictate the business relationships between PBMs and their customers. Rather, accreditation can provide the assurance that, notwithstanding different business models, the content of what is provided to clients and their members meets acceptable standards.”

The initial set of standards is designed for the commercially insured population. Proposed standards for the Medicare population are expected to be released for comment in January, 2007. The standards were developed by URAC’s 38-member Pharmacy Benefits Management Advisory Committee, which includes a wide range of stakeholders: employers, consumers, pharmacy consultants, health plans, independent retail pharmacy, pharmacy benefits management organizations, pharmacy professional organizations, labor, and large public purchasing groups.

“The pharmacy benefits management industry recognizes that this is the right time for industry-wide standards,” said John D. Jones, RPh, JD, vice president of government affairs and pharmacy policy for Prescription Solutions and chairman of URAC’s Pharmacy Benefits Management Advisory Committee. “The PBM industry wants to identify and use best practices. URAC PBM accreditation standards will provide a uniform approach that PBM organizations can use to demonstrate best practices across the board.”

URAC’s pharmacy benefits management standards address a wide range of industry practices across seven modules:

• Organizational Integrity
• Customer Service/Communications/Disclosure
• Pharmacy Distribution Channels
• Drug Use Management
• Formulary/P & T
• Medication Therapy Management
• Benefit Design/ Administration

“Over the last three months of development, we have enjoyed robust discussion from the Pharmacy Benefits Management Advisory Committee,” John P. DuMoulin, MS, CAE, URAC’s vice president of government relations and product development. “We welcome and expect significant input during this comment period.”

For additional reading:

(1) URAC COMMITTEE MEETS TO SET STANDARDS FOR PHARMACY BENEFIT MANAGEMENT PROGRAMS- Issues discussed include patient safety, medication therapy management

http://www.urac.org/press/cmsDocument.aspx?id=387

(2) Frequently Asked Questions about URAC’s PBM Program

http://www.urac.org/programs/faqs.aspx

(3) URAC Maps Uncharted Territory with PBM Standards (Issue Brief)

http://www.urac.org/savedfiles/URACoctoberv5HighRes.pdf