URAC Pharmacy Benefit Management accreditation.
March 1, 2023 – March 1, 2026
URAC Pharmacy Benefit Management Accreditation
MedImpact Healthcare Systems, Inc. has full URAC Pharmacy Benefit Management accreditation for Commercial, Marketplace Exchange, Medicare, and Managed Medicaid lines of business.
For Medicaid Fee For Service (FFS) business that is directly contracted with a State and administered by MedImpact, functioning as the State’s Pharmacy Benefit Administrator (PBA), MedImpact adheres to URAC standards where possible. Where State functional processes and standards may not align with URAC standards, MedImpact must follow the Medicaid FFS client’s requirements as the Administrator of those benefits. For these FFS clients, MedImpact does not own or manage the State’s pharmacy network, nor make decisions on program formulary or utilization review criteria. These State requirements cannot be revised by MedImpact and are administered as directed by the State Agency.
The three-year URAC accreditation for PBM covers 10 quality modules: operations and infrastructure; formulary and drug management; network management; consumer protection and empowerment; client relations; risk management; pharmacy and therapeutics committee; performance monitoring and improvement; member service and communication; and performance measures.
URAC is known in the industry as the independent leader in promoting healthcare quality by setting high standards for clinical practice, consumer protections, performance measurement, operations infrastructure, and risk management.
