URAC COMMITTEE MEETS TO SET STANDARDS FOR PHARMACY BENEFIT MANAGEMENT PROGRAMS
Issues discussed include patient safety, medication therapy management
08/15/2006
Washington, D.C. August 15, 2006 – Patient safety and access issues, information and financial disclosure, medication therapy management and drug use management were the topics of discussion as a multi-stakeholder committee charged with developing requirements for the nation’s first-ever accreditation programs for pharmacy benefits management met in Washington, D.C. the last week in July.
The 34 members of URAC’s Pharmacy Benefit Management Standards Committee represent a wide range of players in the field: employers, consumers, pharmacy consultants, health plans, independent retail pharmacy, pharmacy benefits management organizations, pharmacy professional organizations, labor, and even large public purchasing groups such as the Office of Personnel Management and the Ohio Public Employees Retirement System.
“We want to give members of the committee from every perspective an opportunity to voice their positions on all the issues we have before us,” said John J. Jones, RPh, JD, chairman of the committee and vice president of government affairs and pharmacy policy at Prescription Solutions, a PBM based in Irvine, Calif., part of Ovations Pharmacy Solutions. “All members have an opportunity to bring up legitimate issues so we can address them. It is important for us to hear a wide representation of interests so we have a spirited debate on the issues.”
Two work groups initiated efforts to create standards falling within two broad categories. The Operations Work Group discussed standards for operational integrity; communications, customer service and disclosure; and pharmacy network. The Clinical Work Group discussed drug use management; benefit design administration; patient safety; formulary development; and medication therapy management.
URAC, the independent, nonprofit health care accrediting organization well-known as a leader in promoting health care quality through its accreditation and certification programs, announced in June formation of the Committee. The Committee is charged to advise URAC on the creation of four related accreditation programs for health plans and pharmacy benefits management organizations providing services to both Medicare and commercially insured populations. The committee will meet throughout the fall and will seek additional input through public comment opportunities. URAC's goal is to complete the development process and launch the accreditation programs in 2007.
“ The creation of standards can focus efforts on prescription benefits management issues of key importance today, such as initiatives to improve patient safety and to provide better access,” said Alan Spielman, URAC’s president and chief executive officer.
In addition to Jones, members of URAC’s Pharmacy Benefit Management Standards Committee are:
- Scott Streator, director of health care, Ohio Public Employees Retirement System;
- Christopher V. Goff, Esq. president and chief executive officer, Employers Health Purchasing Corporation of Ohio;
- Cindy Kirman, Rph, Pharm.D., director of pharmacy, General Motors;
- David Hom, vice president, strategic human resources initiatives, Pitney Bowes;
- Babette Edgar, Pharm.D, MBA, vice president, strategic business development, Gorman Health Group;
- James Lang, Pharm.D., MBA, pharmacy management consultant, Scheller Bradford Group;
- Janice Anderson, managing director of pharmacy, Blue Cross and Blue Shield Association;
- Rusty Hailey, Pharm.D., DPh, MBA, chief pharmacy officer and senior vice president pharmacy services, Coventry Health Care, Inc.;
- Brian Sweet, Rph, MBA, vice president of clinical services, WellPoint Pharmacy Management;
- Mark Rubino, Chief Pharmacy Officer, Aetna;
- John Tilley, president-elect for 2007, National Community Pharmacists Association;
- John Coster, RPh, PhD, vice president for policy and programs, National Association of Chain Drug Stores;
- Greg Drew, vice president, Rite Aid Inc.;
- Judith Cahill, CEBS, executive director, Academy of Managed Care Pharmacy;
- Susan Winckler, RPh, Esq., vice president for policy and communications, staff counsel, American Pharmacists Association;
- Pamela T. Miller, Esq., vice president, market strategy and development, Medco Health Solutions, Inc.;
- Elaine Manieri, area vice president of clinical affairs, CareMark Rx, Inc.
- Diane Nobles, executive vice president, compliance and integrity, CareMark Rx, Inc.;
- Vernon C. Rowen, vice president, government affairs, Express Scripts;
- Greg Johnson, senior director, federal affairs, Pharmaceutical Care Management Association;
- Mike Bailey, RPh, director of pharmacy business, MedImpact Healthcare Systems Inc.;
- Pamela Hara, BSN, MBA, CPHQ, senior vice president quality and outcomes Healthways, Inc.;
- Brian L. Kallach, R. Ph, director, professional services center, MemberHealth, Inc.;
- Joseph E. Addiego, Jr., M.D., vice president, chief medical officer, Prescription Solutions, part of Ovations, Pharmacy Solutions;
- Alan T. Wright, MD, MPH – vice president, product strategy and business development, Resolution Health, Inc.;
- Shirley Patterson, chief of insurance contract division 1, Office of Personnel Management;
- Anne Easton, chief insurance policy group, Office of Personnel Management;
- Jack Hoadley, Ph.D., research professor, Georgetown University Health Policy Institute;
- Anne Trontell, MD, MPH Senior Advisor on Pharmaceutical Outcomes, Agency for Healthcare Research and Quality (AHRQ);
- Bill Vaughan, senior policy analyst, Consumers Union;
- Carol Malone, senior health care specialist, National Education Association;
- Rebecca Snead, executive vice president/chief executive officer, National Alliance of State Pharmacy Associations;
- Connie Commander, RN, BS, CCM, ABDA, CPUR, president, Case Management Society of America.
Additional Reading:
“URAC SETS STANDARDS FOR PHARMACY BENEFIT MANAGEMENT PROGRAMS- ENSURING PATIENT SAFETY, CONSUMER PROTECTION” http://www.urac.org/press/cmsDocument.aspx?id=398