The Basics

One of the reasons we have emphasized in the previous couple of pages the importance of having required contract language embodied in the pharmacy provider manual and/or policies and procedures is because of the existence of this standard.  Because it is not expected that you will go out and recontract with all of the participating pharmacies in your network with which you have agreements that do not comply with these accreditation standards, you may make up for the non-compliance of these older contracts by having the required terms in these administrative documents.  The reason we recommend having the required language incorporated into your pharmacy provider manual is that this is a document that you share with your pharmacies, whereas you may not share all of your policies and procedures with pharmacies.

Management Tips

Naturally, this standard is not applicable in the event that all of your pharmacy agreements comply with the previous couple of standards.  However, because there is a possibility that, somewhere out there, you have a letter of agreement or an old contract that does not comply with the requirements of these standards, it is a best practice to make sure that your provider manual contains all of the required language for your pharmacy contracts.

URAC Accreditation Tips

Each element of the standard is weighted 4.

Documentation for this standard is straightforward, in that you need only submit the pharmacy provider manual and/or policies and procedures that "fill in the gaps" of your provider agreements.

In addition to the review of contracts described previously, the on-site review will involve an interview with network management staff and leadership as well as an examination of any tracking mechanisms you have for pharmacy agreements.