URAC PBM Standards Development Racing into Beta Stage

Draft, public comment, redraft, beta reviews, redraft, and approve.

That's the basic sequence for developing a new set of accreditation standards at URAC. While sometimes it seems as though this is a long, slow process (and sometimes it is), there are passages that seem like the Indy 500. In the history of the development of the URAC Pharmacy Benefit Management ("PBM") accreditation standards, now is one such time.

The public comments are in, and the second draft is being worked on. Yet, within a matter of weeks, URAC accreditation reviewers will be showing up on the doorsteps of the companies participating in the "beta" process to conduct their onsite reviews.

So, if you're a PBM that is participating as a beta applicant, some time in the next few days you'll get a copy of the revised standards and need to start gathering documents like crazy to be ready for the knock on your front door that could be as early as mid-March.

Now, of course, the beta process at URAC is different from the normal application process. The normal approach is to submit an application, receive an evaluation of that application from the reviewer(s), respond to that evaluation (called the "Desktop Review Summary") with additional documentation, then submit your organization to an onsite review. In the beta process, you gather your documents together, engage in a more dialogic back-and-forth with the reviews (and sometimes observers) during the onsite review, and then pull your formal application together after the reviewers have left.

Despite this difference faced by beta applicants, there is a big demand for fast action at this phase of the game. Staff training, gap analysis, document assessment and review, revision of P&Ps, mock onsite reviews, and much more, all within the next 30 business days. One of our clients is in this select crew, and we launch our effort tomorrow.

Ladies and gentlemen, start your engines.