NCQA Accreditation and Certification add to the pharmacy benefit manager’s growing list of industry recognitions
PRESS RELEASE: March 31, 2020 – EnvisionRx, a pharmacy benefit manager (PBM) and division of EnvisionRxOptions, a wholly owned subsidiary of Rite Aid Corporation, today announced it has received Accreditation in Utilization Management and Health Information Products Certification for Pharmacy Benefits Information from the National Committee for Quality Assurance (NCQA), a private, nonprofit organization dedicated to improving healthcare quality that accredits and certifies a wide range of healthcare organizations. These achievements add to those the company already holds, including accreditations from URAC for Pharmacy Benefit Management and Drug Therapy Management. The pharmacies division of EnvisionRxOptions also holds accreditations for its mail and specialty pharmacies, including URAC for Mail Order and Specialty Pharmacy Services, Specialty Pharmacy Services from the Accreditation Commission for Health Care (ACHC), and Verified Internet Pharmacy Practice Sites® (VIPPS®) for mail pharmacy from the National Association of Boards of Pharmacy® (NABP®).
Accreditation in Utilization Management Demonstrates Dedication to Quality Care
The NCQA Utilization Management Accreditation is a quality assessment program that focuses on consumer protection and improvement in service to customers. Standards recognize that organizations that apply for accreditation have open access networks, and can improve service quality and utilize customized structures to meet purchaser needs.
“Achieving NCQA Utilization Management Accreditation demonstrates that EnvisionRx has the systems, processes and personnel in place to conduct utilization management in accordance with the strictest quality standards,” stated Margaret E. O’Kane, president of NCQA.
"When it comes to utilization management tactics, not all approaches are equal,” stated Dan Robson, president of EnvisionRxOptions. “While it may seem that denying drugs would save the plan money, the lack of necessary medication could lead to undesirable health outcomes and even more complications. On the other hand, allowing more drugs without assessing appropriateness could needlessly drive up spend. Our balanced approach ensures patients receive the right medication, at the right time and for the right price. Our utilization management programs offer clinically sound solutions based on indication, effectiveness, safety and adherence to drive improved health outcomes for members.”
One of Only Three Organizations to Earn Certification for Pharmacy Benefits
The NCQA Health Information Products (HIP) Certification for Pharmacy Benefits is a quality assessment program that health plans can use to assess organizations that develop and provide content, tools and services in pharmacy benefits. EnvisionRx is one of only three organizations to earn this Certification. The process included evaluation of EnvisionRx’s management of various aspects of its data collection and systems operation, and the process it uses to continuously improve the services it provides.
"Pharmacy benefits have become increasingly and unnecessarily complex. EnvisionRx was founded on the simple idea of doing things differently and aligning our interests with those of our clients and their members. This Certification proves that we are helping to simplify pharmacy benefits for our clients and improve the quality of care for patients," said Robson.