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CVS Health Receives NCQA Utilization Management Accreditation

March 22, 2018 | Pbm

WOONSOCKET, R.I., March 22, 2018 /PRNewswire/ -- CVS Health (NYSE: CVS) announced today that its pharmacy benefits manager (PBM) CVS Caremark was accredited by NCQA in Utilization Management (UM). NCQA Utilization Management Accreditation is a quality assessment program that focuses on consumer protection and customer service improvement. Standards recognize that organizations that apply for accreditation have open access networks, and can improve service quality and utilize customized structures to meet purchaser needs.

"At CVS Caremark, we are pleased to maintain our NCQA Utilization Management Accreditation, which we've held continuously for the past several years," said Jonathan Roberts, Chief Operating Officer of CVS Health. "This accreditation affirms that our program provides high quality service and care to our PBM clients and their members as we strive to ensure that members access clinically appropriate and cost effective therapies to help improve health outcomes and lower costs."

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 our clients. The program is based on evidence-based drug information, published guidelines, consensus statements and standards of medical practice.

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

The Accreditation Survey includes a rigorous evaluation conducted by a team of physicians and managed care experts. An independent review oversight committee of physicians analyzes the team's findings and assigns an accreditation status based on the organization's performance against standards. NCQA has reviewed and accredited CVS Health's Utilization Management functions only. For complete details on the scope of this review, visit

About CVS Health

CVS Health is a pharmacy innovation company helping people on their path to better health. Through its more than 9,800 retail locations, more than 1,100 walk-in medical clinics, a leading pharmacy benefits manager with more than 94 million plan members, a dedicated senior pharmacy care business serving more than one million patients per year, expanding specialty pharmacy services, and a leading stand-alone Medicare Part D prescription drug plan, the company enables people, businesses and communities to manage health in more affordable and effective ways. This unique integrated model increases access to quality care, delivers better health outcomes and lowers overall health care costs. Find more information about how CVS Health is shaping the future of health at

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 is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

Christina Beckerman
CVS Health