URAC Specialty Pharmacy Accreditation Consulting
Last updated: October 2026
URAC Specialty Pharmacy Accreditation is URAC's accreditation program for specialty pharmacies, and Integral Healthcare Solutions (IHS) prepares specialty pharmacies for it with a Standard-by-Standard Review, drafted policies and documentation, and a mock review before the real one.
URAC is the Utilization Review Accreditation Commission, and it decides whether a pharmacy is accredited. Integral Healthcare Solutions (IHS), founded in 2002 by Thomas G. Goddard, JD, PhD, former URAC COO and General Counsel, has consulted on URAC accreditation since 2002. IHS drafts the policies, procedures and documentation for your pharmacist-in-charge and quality team to review and approve. Your organization's named contact submits the application, and IHS does not take part in URAC's decision. Specialty pharmacy FAQ | Cost guide | URAC vs ACHC comparison
Who pursues URAC specialty pharmacy accreditation?
These organizations typically ask IHS about it:
- Independent specialty pharmacies seeking network participation
- Hospital and health system outpatient pharmacies
- Specialty pharmacies owned by or affiliated with pharmacy benefit managers
- Pharmacies that handle rare disease and limited distribution drugs
- Mail service pharmacies, which may pursue URAC Mail Service Pharmacy Accreditation alongside or instead of the specialty designation
- Small independent pharmacies, which may look at URAC's Small Business Specialty Pharmacy Accreditation program
Why can accreditation matter for network access?
PBMs, manufacturers, and payers may require accreditation for network inclusion, limited distribution drug access, and contract eligibility, and each sets its own requirement. Accreditation requirements for specialty network participation sit in each PBM's network terms, so confirm them with each PBM you contract with.
State law can address this too. North Carolina Session Law 2025-69 (Senate Bill 479, page opened October 4, 2026) defines a specialty pharmacy as one accredited by a nationally recognized, independent accrediting organization and names URAC, the Accreditation Commission for Health Care (ACHC), the National Association of Boards of Pharmacy (NABP) and the Joint Commission, or their successors, as bodies that may issue the accreditation. The same law states that a pharmacy benefits manager "shall not require multiple specialty pharmacy accreditations as a prerequisite for participation in a retail pharmacy network that dispenses specialty drugs." Its PBM section is effective October 1, 2025 and applies to contracts entered into, renewed or amended on or after that date.
How does URAC specialty pharmacy accreditation work with IHS?
IHS plans for 9 to 12 months from engagement kickoff to a committee decision, depending on how much of your documentation and patient management work already exists. The phases below are IHS's process.
Phase 1: Standard-by-Standard Review (months 1-2)
IHS conducts a Standard-by-Standard Review: a gap assessment of your pharmacy against every applicable standard in the version of the URAC Specialty Pharmacy standards that applies to your review. You receive a list of the documentation to build, revise or create, with an estimate of the time each element will take.
Phase 2: Document preparation (months 2-5)
IHS provides policy templates and helps your team write and customize policies and procedures to your operations. That includes Patient Management program frameworks, Quality Management Committee charter templates and clinical documentation templates, which your team adapts to your workflows and software. IHS does not interact with your dispensing software or conduct staff training directly. IHS equips your internal team with the compliance frameworks it needs to build and sustain the operation.
Phase 3: Application through AccreditNet (months 5-6)
The application defines your scope of services, organizational structure and any delegation activities. Your organization's named contact submits it through URAC's AccreditNet platform. IHS prepares and reviews the documentation package and organizes evidence by standard to help reduce avoidable requests for information.
Phase 4: Desktop review and RFI response (months 6-7)
URAC reviews the submission against the standards and may issue Requests for Information (RFIs) on gaps or ambiguities. IHS drafts each RFI response to the concern the reviewer raised, rewriting policies and strengthening evidence, for your organization to submit.
Phase 5: Validation review (months 7-8)
URAC validates that your operations match the policies you documented. IHS runs a Mock Validation Review with mock interview sessions, a facility walkthrough rehearsal and patient file audits so your staff can show how they work.
Phase 6: Committee decision (months 8-9)
URAC's Accreditation Committee makes the accreditation decision. IHS has no role in it, and your organization receives the decision from URAC.
What does your pharmacy need to staff internally?
Accreditation is not a consultant-only project. A pharmacist-in-charge leads clinical policy adaptation and staff training. A quality assurance or compliance manager runs document control, AccreditNet and RFI responses. External consultants cannot generate your site-specific clinical data or train your staff for you. IHS supplements your team's capacity and does not replace it, so your staff can maintain accreditation after the engagement.
What does IHS review closely before a URAC specialty pharmacy review?
IHS's Standard-by-Standard Review checks your documentation against each area below before submission. The URAC standards decide what a reviewer scores.
- Primary source verification of clinical licensure and credentials, with dates and the frequency your policy and the standards set
- Patient management clinical assessments documented at initiation of therapy in your pharmacy management software
- Temperature qualification testing and cold-chain documentation for shipments
- Grievance and complaint packets that include the state regulatory agency contact information for your state
- Care plans tailored to each patient's conditions and medications instead of one boilerplate plan
- Staff competency assessments that are complete and consistent for each role
- A process to collect, check and submit performance measures on schedule
- Quality committee minutes with root cause analysis and follow-up items that have owners and deadlines
- Documentation organized by standard rather than scattered across spreadsheets
What does URAC specialty pharmacy accreditation cost?
The cost has three parts: URAC's fees, your own staff time and the IHS consulting fee. URAC sets its own fees. IHS has not found a published URAC fee schedule for specialty pharmacy accreditation, so this page states no URAC figure. Ask URAC for a quote for your pharmacy and verify current fees with URAC before you budget. Your staff time depends on how much documentation and patient management work already exists.
IHS sets a fixed fee for each engagement after a free discovery session, because scope, number of sites and gap severity change the work. The URAC specialty pharmacy cost guide lists each cost category.
What this is not
IHS is not URAC and is not an accrediting body. IHS does not grant, schedule or influence an accreditation decision.
IHS does not file anything for you. Your organization's named contact submits, and IHS drafts the supporting documents.
IHS does not give legal advice. Whether a payer or state law requires accreditation of your pharmacy is a question for your counsel and your contracts.
IHS does not guarantee that URAC will accredit your pharmacy, and it does not provide software or staff training.
Who leads IHS URAC engagements?
Thomas G. Goddard, JD, PhD, founded IHS in 2002 and was URAC's Chief Operating Officer and General Counsel before that. Dr. Goddard personally leads IHS's URAC and program-development engagements, so you work directly with him. IHS advises hospital-owned specialty pharmacies on URAC accreditation. For pharmacies weighing URAC against ACHC, IHS advises on sequencing and on reusing documentation across both programs. See the URAC vs ACHC comparison, the specialty pharmacy accreditation comparison matrix and specialty pharmacy start-up program design, and the accreditation consulting overview.
Frequently asked questions
What is URAC specialty pharmacy accreditation?
It is URAC's accreditation program for specialty pharmacies, run by the Utilization Review Accreditation Commission. IHS prepares pharmacies for it and does not take part in URAC's decision.
Which PBMs require URAC specialty pharmacy accreditation?
Accreditation requirements for specialty network participation sit in each PBM's network terms, so confirm them with each PBM you contract with.
How long does URAC specialty pharmacy accreditation take?
IHS plans for 9 to 12 months from consulting engagement kickoff to committee decision. The time depends on whether your pharmacy already has compliant policies, working patient management programs and audit-ready documentation. The phases are Standard-by-Standard Review, document preparation, application, desktop review, validation review and committee decision.
How much does URAC specialty pharmacy accreditation cost?
URAC sets its own fees, and IHS has not found a published URAC fee schedule, so ask URAC for a quote and verify current fees with URAC. IHS sets a fixed fee for each engagement after a free discovery session. See our cost guide for the cost categories.
What is the difference between URAC and ACHC specialty pharmacy accreditation?
Both accredit specialty pharmacies, and their standards, fees and processes differ. A pharmacy can hold both. See our full comparison.
What does a URAC specialty pharmacy accreditation consultant do?
A consultant reviews your pharmacy against the standards, drafts policies and documentation for your team to approve, prepares the documentation package for AccreditNet upload, runs mock reviews and drafts RFI responses. IHS provides this support from the initial assessment through the committee decision, and your organization submits to URAC.
Is there a URAC program for small specialty pharmacies?
Yes. URAC has a Small Business Specialty Pharmacy Accreditation program for smaller pharmacies. Eligibility and pricing are set by URAC, so confirm them with URAC. See the small business program page.
What does North Carolina's 2025 pharmacy law say about accreditation?
North Carolina Session Law 2025-69 (Senate Bill 479) lists URAC, ACHC, NABP and the Joint Commission in its specialty pharmacy definition. It bars a PBM from requiring multiple specialty pharmacy accreditations for participation in a retail pharmacy network that dispenses specialty drugs.
Who communicates with the accreditor, IHS or my organization?
Your organization. Your named contact submits the application and answers URAC, and IHS drafts the supporting documents and RFI responses.
Who is this not for?
This is not for a pharmacy that wants IHS to deal with URAC for it, a pharmacy that needs a legal opinion on a payer or state requirement, or one that expects IHS to supply dispensing software or train its staff. IHS does none of those.
Ready to plan your URAC specialty pharmacy accreditation?
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