Committee

After a several-year dormancy, the idea of a URAC Accreditation Program for Pharmacy Benefit Managers (PBMs) has reawakened. URAC announced today that it has formed a committee to develop standards for PBMs. This comes years after the PBM industry first started discussions with all the major managed care accreditation bodies to see who would be interested in developing such standards.

None of the accreditation organizations were ready for the idea in the early part of this decade, when the idea was first floated. I'm guessing that URAC is better prepared to step into this arena since the advent more recently of the Core Standards, which provide a baseline of sound management practices across all types of organizations. This narrows the range of issues to be hammered out, since the "management 101" principles are handled in the Core module.

What will be interesting to see is how the committee handles the fact that non-M.D. pharmacists typically make the UM-like decisions in the drug use management component of PBM operations. I surmise that once that issue has been resolved (if it has not already been resolved), the rest of the issues will go pretty smoothly.