- Receipt of the NCQA Utilization Management Accreditation demonstrates Capital Rx’s commitment to consumer protection and customer service improvement
NEW YORK, April 10, 2024 /PRNewswire/ — Capital Rx, the full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA) advancing our nation’s healthcare infrastructure to improve drug price visibility and patient outcomes, has received National Committee for Quality Assurance (NCQA) Accreditation in Utilization Management. NCQA Accreditation is a voluntary review process, and Capital Rx proved that the necessary systems, processes, and personnel are in place to meet the NCQA’s strict quality standards.
“I am proud of Capital Rx earning NCQA’s Accreditation in Utilization Management,” said AJ Loiacono, Co-Founder and CEO of Capital Rx. “Leveraging JUDI®, our enterprise health platform, we met the standards necessary to achieve NCQA’s qualification in our first review. While other organizations have struggled with or overlooked this critical qualification, we believe NCQA’s standards are an essential framework for benefit administrators and represent the highest level of clinical excellence. Through our continual investment in JUDI’s capabilities and our commitment to constantly improving care delivery, Capital Rx will ensure the highest level of clinical program support for our customers.”
NCQA Standards recognize that organizations that apply for accreditation have open access networks, can improve service quality, and utilize customized structures to meet purchaser needs. Further, NCQA Utilization Management Accreditation helps reinforce that organizations making utilization management decisions are following objective, evidence-based best practices.
Capital Rx’s JUDI is redefining the role technology plays in administering pharmacy programs across commercial, Medicare, and Medicaid plans. Sara Izadi, PharmD, Capital Rx’s Chief Clinical Officer, said, “Our prior authorization tool (PAT) is intuitively built into JUDI, allowing formulary and clinical criteria integration, a built-in test claim feature leveraging real-time adjudication, the ability to create authorizations directly from a PA case review, and other streamlined workflows. These integrated features make adherence to evidence-based guidelines easier, and, importantly, they ensure patients have timely access to proper care.”
NCQA has reviewed and accredited Capital Rx’s Utilization Management functions only. For complete details on the scope of this review, please visit www.ncqa.org.
About NCQA
NCQA is a private, nonprofit 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 website (ncqa.org) contains information to help consumers, employers, and others make more informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.
About Capital Rx
Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company’s cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare. To learn more, visit capitalrx.com.
Media Contacts
Michael Passanante, Senior Vice President, Marketing & Communications
Justin Venneri, Director, Communications
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SOURCE Capital Rx
