Sustainable FQHC Pharmacy Services with Specialty Pharmacy Accreditation

In general, a specialty pharmacy accreditation is required by insurers to dispense specialty medications at a pharmacy. Attaining accreditation helps FQHCs (Federally Qualified Health Centers) develop a sustainable pharmacy service, that serves the communities needs directly.

While there is no strict federal mandate requiring FQHCs (Federally Qualified Health Centers) to use only specialty pharmacies with accreditation, many payers and insurance companies do require specialty pharmacies to be accredited in order to contract with them, which could indirectly necessitate an FQHC to utilize an accredited specialty pharmacy when referring patients for specialty medications; this is because insurers often prefer to work with pharmacies demonstrating high quality standards through accreditation.

Key points to consider:

• Specialty Pharmacy Services: A Pharmacy operating within an FQHC can provide direct advanced care for patients with chronic or complex conditions requiring specialized medications, including medication counseling, adherence monitoring, and coordination with other healthcare providers. 
• Patient care: Accreditation ensures a specialty pharmacy meets standards for patient management, medication therapy management, and overall quality of care, which is crucial for FQHC patients often managing complex medical conditions.
• Sustainability: The pharmacy model is designed to be financially sustainable by optimizing medication utilization, managing costs, and utilizing reimbursement opportunities for specialty pharmacy services.
• Reimbursement: Many payers may limit reimbursement for specialty medications to prescriptions dispensed through accredited pharmacies, putting pressure on FQHCs to use them.

URAC Specialty Pharmacy Accreditation will bring your FQHC organization, better patient outcomes, while enhancing your patient experiences, while growing our centers reputation and financial stability.