Pharmacy Benefit Management

What is a pharmacy benefit management company?

A pharmacy benefit management (PBM) company is a third-party administrator of prescription drug programs. It processes and pays prescription drug claims, develops and maintains the formulary, contracts with pharmacies, and negotiates discounts and rebates with drug manufacturers.

What is URAC’s PBM Accreditation?

URAC’s PBM Accreditation standards cover the organization’s contract terms and pricing structures; ensure access to drugs and pharmacies; provide for drug utilization management, formulary management, patient safety and customer service; and create a process for PBM outcomes measurement and quality improvement. It is a critical seal of approval for employers, consumers, regulators, and providers.

The program offers unmatched prestige for an organization, whether it is a PBM or health plan. It delivers the first-ever national standards, key benchmarks in service quality, and continuous quality improvement-oriented processes that enhance operations and compliance.

Who may apply?

Pharmacy benefit management companies, health plans, and other health care organizations may apply.

 

Interested in accreditation?
Contact businessdevelopment@urac.org

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