WHAT IS SPECIALTY PHARMACY ACCREDITATION?
NCQA Specialty Pharmacy Accreditation is a comprehensive, standards-based program dedicated to quality improvement that evaluates a specialty pharmacy’s ability to deliver patient-centered care. NCQA-Accredited pharmacies demonstrate best practices for delivering the right medication to the right patient, at the right time—with well-coordinated patient care and follow-up.
HOW DOES SPECIALTY PHARMACY ACCREDITATION HELP MY ORGANIZATION?
NCQA Specialty Pharmacy Accreditation helps your organization demonstrate its commitment to quality improvement and delivery of patient-centric care. It provides a framework for alignment with your contracting partners:
- Supports and indicates contract readiness.
- Reduces survey prep time through intuitive design around the patient and script journey.
- Identifies barriers to therapy initiation and adherence.
- Comprises clearly written standards; surveyors are experienced pharmacists.
WHAT ARE THE SPECIALTY PHARMACY ACCREDITATION REQUIREMENTS?
NCQA Specialty Pharmacy Accreditation assess an organization’s performance in these key areas:
- Patient Programs.
- Organization, Administration and Compliance.
- Specialty Pharmacy Operations.
- Quality and Performance Improvement.
WHERE CAN I FIND THE STANDARDS AND GUIDELINES?
Find the Standards and Guidelines document in the NCQA Store.
WHAT ORGANIZATIONS ARE ELIGIBLE FOR SPECIALTY PHARMACY ACCREDITATION?
Any organization that dispenses or seeks to dispense specialty medications and provides or seeks to provide supporting patient care services may apply for an NCQA Specialty Pharmacy Accreditation Survey if it meets the following criteria:
- Operates under a pharmacy license.
- Is the legal entity that engages in or seeks to engage in contracts with health plans and/or pharmaceutical benefit managers to provide specialty pharmaceuticals and supporting services to their members.
- Is the legal entity that engages in or seeks to engage in contracts with a pharmaceutical manufacturer to dispense specialty medications.
- Provides programs and services to patients to support medication adherence and achieve optimal therapeutic outcomes.
- Performs functions addressed in the Standards and Guidelines for the Accreditation of Specialty Pharmacies (PT, OAC, SPO, QI), either directly or through a service agreement.
- Complies with applicable federal, state and local laws and regulations, including requirements for licensure.
- Does not discriminate based on gender, sexual orientation, race, creed or national origin.
- Has a process for monitoring, evaluating and improving the quality and safety of care provided to its patients.
HOW DO WE EARN SPECIALTY PHARMACY ACCREDITATION?
The first step to earning this Accreditation is a discussion with an NCQA program expert. Next, purchase and review the program resources, conduct a gap analysis and submit your online application.
Align your organization’s processes with the standards. NCQA conducts the Accreditation Survey and determines your status within 30 days of the final review.
HOW LONG DOES IT TAKE TO EARN SPECIALTY PHARMACY ACCREDITATION?
The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.
HOW DO WE START?
If you are not currently Accredited and want to learn more, contact NCQA.
If you are currently Accredited and want to talk to someone about your status or about renewing or adding Accreditations, submit a question through My NCQA.
WHERE CAN I FIND INFORMATION?
- Accreditation Process and Timeline: Key steps, timing and resources for a successful Accreditation journey.
- Standards and Guidelines: The complete standards and guidelines, including the intent statement and scope of review.
- Interactive Survey Tool: The complete standards and guidelines. You can also determine your organization’s survey readiness—the tool calculates your potential survey score.
WHAT ORGANIZATIONS HAVE EARNED NCQA ACCREDITATION?
NCQA accredits a wide range of health care organizations. See the NCQA Report Card for a directory of accredited organizations.