URAC’s New Specialty and Mail Service Pharmacy Accreditation Standards, v. 5.0: Part 1
(Risk Management and Compliance)

In October 2022, URAC unveiled the new Specialty Pharmacy and Mail Service Pharmacy Accreditation Programs, v. 5.0. In this video, the first of a series of eight videos, we explore what’s new as it relates to the Risk Management module within those two accreditation programs.

In this educational video, IHS's CEO, Dr. Tom Goddard, sits down with the company's Chief Operating Officer and Senior Pharmacy Consultant, Dr. Jill Paslier, to discuss the changes in the URAC Specialty Pharmacy and Mail Service Pharmacy accreditation standards between version 4.0 and version 5.0.

Jill shares her insights and expertise on the updated standards, highlighting the key changes that impact specialty and mail service pharmacies seeking URAC accreditation. She also offers practical advice on how specialty pharmacies can ensure they meet the new requirements and maintain their accreditation status.

Whether you are a specialty or mail service pharmacy owner, operator, or clinician, this video is a must-watch. You'll gain valuable knowledge and a deeper understanding of the URAC Specialty Pharmacy and Mail Service Pharmacy accreditation standards and what it takes to achieve and maintain accreditation in today's healthcare landscape. So, sit back, relax, and get ready to learn from the experts at IHS!

Topics covered include:

  • Risk Management

  • Compliance Auditing

  • Business Continuity Plan

  • Emergency Management Plan

  • Information Systems Risk Assessment

 

Transcription

[00:00:08.460] - Thomas Goddard

Good morning. My name is Tom Goddard. I'm the Founder and Chief Executive Officer of Integral Healthcare Solutions. For almost 21 years, we've been helping URAC accredited companies go through, or applicants for URAC accreditation go through the URAC process, as well as other accreditation organizations like the ACHC, Joint Commission, and an ABP. Today, we're going to talk about URAC's new specialty pharmacy, which, of course, includes male service pharmacy standards, version 5.0. I'm joined today by one of our our senior pharmacy consultants, Jill Paslier. Jill, tell us a little bit about your background in pharmacy and your background as it relates to your accreditation and how we met even.

 

[00:01:12.800] - Jill Paslier

Sure. Yeah, My name is Jill Paslier. I'm one of the senior consultants with IHS. I've been working in specialty pharmacy since about 2007. First as a technician, I did a rotation as an intern and then as a pharmacist for a number of years with the health system in Arizona. Which is actually where I met Tom and the IHS team. They were our consultants a number of years back. Then since then, I did a postdoctoral fellowship in medication safety with the Institute for Safe Medication Practices. Then I've been with IHS for about a year and a half, almost two years doing accreditation consulting. So happy to be here and share some of the updates with the URAC Specialty and mail service 5.0 standards.

 

[00:02:00.110] - Thomas Goddard

And just to be clear for those who are new to these standards, mail service is really a subset of specialty pharmacy. Specialty pharmacy can be seen loosely as mail service plus patient management from the URAC perspective. There are two broad categories of standards in all URAC programs, and specialty and Mail service pharmacy are no exception. And there are the clinical standards and the non-clinical standards, and they're lumped into focus areas. And so we're going to be going through these focus areas. Jill, you've been combing through the new standards very closely as you've been developing our policy and procedure templates for our clients based on the new standards. And as we prepare to write up our own interpretive information to supplement and augment the URAC interpretive information that comes with the standards that you purchase from URAC. So let's just go through the sections or the focus areas one at a time, starting with risk management, the RM standards. What really jumped out to you, if anything, about the changes you saw in the RM standards, Jill?

 

[00:03:12.400] - Jill Paslier

Yeah. In this section, mostly some concepts have been removed. There haven't really been any new concepts or new things that you'll have to do, which will make it a little bit easier for clients transitioning from the 4.0 to the 5.0. I'll just go over some of the main changes as far as what's been removed. With your compliance program, historically, you had to have a process for ongoing internal monitoring, auditing, and reporting. Now, the standard is just specifically saying you need to audit compliance. That might just be a little bit more specific to how you're going to be managing that program. The next change is regarding reporting of violations, like retaliation, failure to report and confidentiality. Probably these topics were covered in your code of conduct policy and that concept has been removed, just having some of those specific details in there. Then for the business continuity plan, there's just been some changes. No longer needing to describe the effect that a disruption would have on your organization, and then no longer needing to include an emergency management plan. That's just a little bit of additional detail that was in the previous standards.

 

[00:04:28.990] - Thomas Goddard

And then- Yeah, the business continuity, that describing the effect of disruption having on the business was, I would say, the most frequently missed element by first-time applicants in our experience. I don't think we lose a thing by getting rid of that requirement. I'm glad to see that one go. Yeah.

 

[00:04:48.380] - Jill Paslier

Then the last change in the RM standards is about the Information Systems Risk Assessment. If you remember from 4.0, previously that needed to be completed by an entity with expertise that has no stake in the outcome. Now that specific detail has been removed. Basically, you still need to do the systems risk assessment, but it's less specific on who needs to complete that.

 

[00:05:10.890] - Thomas Goddard

That was probably the most frequently deliberately missed element in all of the URAC standards, not just in the specialty pharmacy standards, the extra expense of getting an outside consulting firm to do your security risk assessment, which is already required for many organizations by HIPAA, seemed to many organizations to be useless. And so I'm glad to see that URAC got rid of this external requirement. Hopefully, they'll translate that over into IHS's own certification in healthcare management, because we've opted out of getting that external body to review our standards. And it's been our only point deduction in both of the times we've been through certification of the URAC. So I'm glad to see that one on its way out.

 

[00:05:56.610] - Jill Paslier

Yeah, so that's it. Those are the changes for RM. Unless you had anything to add, we can move on to that.

 

[00:06:02.920] - Thomas Goddard

It sounds like a much needed and welcome simplification and reduction in the URAC requirements for risk management.