CVS Caremark certified by NCQA in Utilization Management

WOONSOCKET, R.I. - CVS Health announced Thursday that pharmacy benefits manager CVS Caremark was certified by NCQA in Utilization Management. NCQA Utilization Management Certification is a quality assessment program that focuses on consumer protection and customer service improvement. Standards recognize that organizations that apply for certification have open access networks, and can improve service quality and utilize customized structures to meet purchaser needs.

 

"At CVS Caremark, we are pleased to earn this important certification from NCQA, which further validates our commitment to providing high quality utilization management services to our clients," stated Jonathan Roberts, president of CVS Caremark. "Utilization management programs help ensure that members access clinically appropriate and cost-effective therapies and as a result, are integral in helping our clients manage costs while improving health outcomes for their members." 

 

The CVS Caremark Utilization Management Program is designed to encourage the appropriate and effective use of medications, identify optimal drug use and promote cost-effective drug benefit plan designs for CVS Caremark clients. The program is based on evidence-based drug information, published guidelines and consensus statements and standards of medical practice, the company stated. 

 

"Achieving Utilization Management certification from NCQA demonstrates that CVS Caremark has the systems, process and personnel in place to conduct utilization management in accordance with the strictest quality standards," said Margaret O'Kane, president, NCQA.

 

NCQA's certification review includes an on- and off-site evaluation conducted by a team of physicians and managed care experts. A review oversight committee of physicians analyzes the team's findings and assigns a certification status based on the organization's performance against standards within applicable certification options.