CVS Health Receives NCQA Certification in Utilization Management

WOONSOCKET, R.I., May 5, 2016 /PRNewswire/ -- CVS Health (NYSE: CVS) announced today that pharmacy benefits manager (PBM) 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," said 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 our clients. The program is based on evidence-based drug information, published guidelines and consensus statements and standards of medical practice.

"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 E. O'Kane, President, NCQA.

NCQA's certification review includes a rigorous 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.

About CVS Health

CVS Health is a pharmacy innovation company helping people on their path to better health. Through its more than 9,600 retail pharmacies, more than 1,100 walk-in medical clinics, a leading pharmacy benefits manager with nearly 80 million plan members, a dedicated senior pharmacy care business serving more than one million patients per year, and expanding specialty pharmacy services, 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

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