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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.