News | January 27, 2017

Prime Therapeutics Is Certified For NCQA Utilization Management And Health Information Products - Pharmacy Benefit Information

Recognition also includes URAC, ACHC and NABP's VIPPS

Saint Paul, MN /PRNewswire/ - National Committee for Quality Assurance (NCQA) has certified Prime Therapeutics LLC (Prime), a leading pharmacy benefit manager (PBM), in two areas: 1) Utilization Management and 2) Health Information Products (HIP) – specifically Pharmacy Benefit Information.

According to NCQA, the HIP Certification in Pharmacy Benefit Information demonstrates Prime's expertise in gathering and disseminating health care information for health plan members and is consistent with NCQA health information standards. The Utilization Management Certification – focused on consumer protection and customer service improvement – shows that Prime's systems, processes and personnel who conduct utilization management reviews follow NCQA's strict quality standards.

"These certifications showcase Prime's commitment to clear communication to members and to help safeguard members so they can get the medicine they need to feel better and live well," said Ann Tobin, chief compliance officer at Prime. "It also means our clients – plan sponsors – can delegate complex prescription drug programs to Prime and have confidence in our service excellence to members."

NCQA Certification is a voluntary review process.

These certifications, which are effective Jan. 1, 2017, are on the heels of Prime also receiving full accreditation from URAC for its pharmacy benefit management, specialty and mail service pharmacies, the Accreditation Commission for Health Care (ACHC) for its specialty pharmacy, and the National Association of Boards of Pharmacy®'s (NABP®) Verified Internet Pharmacy Practice Sites® (VIPPS®) accreditation for its mail service pharmacy.

About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and delivers medicine to members, offering clinical services for people with complex medical conditions. Prime serves just over 22 million people. It is collectively owned by 14 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans.

For more information, visit or follow @Prime_PBM on Twitter.

About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA's Web site ( contains information to help consumers, employers and others make more informed health care choices.

About URAC
URAC, an independent, nonprofit organization, is a well-known leader in promoting healthcare quality through its accreditation, education, and measurement programs. URAC offers a wide range of quality benchmarking programs and services that model the rapid changes in the healthcare system and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire healthcare industry. For more information, visit

About ACHC
ACHC is a non-profit accreditation organization that has stood as a symbol of quality and excellence since 1986. ACHC offers nationally recognized accreditation services for home health, hospice, and private duty agencies. The organization has Centers for Medicare & Medicaid Services (CMS) Deeming Authority for Home Health, Hospice, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), and a Quality Management System that is certified to ISO 9001:2008. ACHC's consultative approach to accreditation is designed to improve the quality of patient care while enhancing business efficiencies through service-specific standards and industry-based best practices. Throughout the entire accreditation process, ACHC is dedicated to delivering the best possible experience.

Since 1999, the Verified Internet Pharmacy Practice Sites® (VIPPS®) program has been accrediting pharmacies that dispense prescription drugs via the internet. Pharmacies that display the VIPPS Seal meet NABP's licensing and inspection requirements of its state and each state to which it dispenses pharmaceuticals, and adheres to a variety of criteria, including meeting nationally endorsed standards of pharmacy practice; demonstrating compliance with standards of privacy and authentication and security of prescriptions; adhering to a quality assurance policy; and providing meaningful consultation between patients and pharmacists.

SOURCE: Prime Therapeutics LLC

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