Punch & Judy: Not accredited yet? Just you wait

Hospital pharmacists are used to this ordeal as part of their institution's accreditation process. Community pharmacists, on the other hand, have not been required to undergo accreditation until now. But things are changing. Accreditation is expanding to the retail world.

Where is accreditation being applied? CMS ruled recently that all providers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) must be accredited if they are to receive and retain a supplier billing number for submitting claims under Medicare Part B. Pharmacies will have to be accredited even if they don't take part in competitive bidding of DMEPOS. This means they will have to meet quality standards applied by independent accrediting organizations that CMS is now in the process of selecting. Some organizations believed to have applied as accreditors are JCAHO, NABP, CHAP, and some state boards of pharmacy.

But DMEPOS suppliers aren't the only group that will have to get used to accreditation quickly. Compounding pharmacies are also getting accredited, although this is being done voluntarily, rather than by fiat, through the Pharmacy Compounding Accreditation Board. PCAB was set up to establish high-quality standards for compounding pharmacies. According to the organization, pharmacies that earn the PCAB-accredited designation have met rigorous patient safety standards and are among the best of the breed. As of June, some 70 compounding pharmacies had applied for accreditation. Considering that compounding pharmacies have gotten a lot of bad press lately, PCAB hopes its accreditation seal will be enough to allay public concerns about the safety of the practice.

Another example of accreditation as applied to community pharmacy can be found in the area of technician training. Some state boards of pharmacy have recently ruled that if technicians are to take on more responsibilities and be deployed in higher pharmacist-to-technician ratios, their training programs must be accredited. Since ASHP is the only organization that currently accredits technician training programs, this will mean that a retail chain will now have to seek accreditation from a hospital pharmacist group. Many chains are opposed to these requirements, since they feel their on-the-job training programs are adequate. But at least one chain, Walgreens, is seeking accreditation from ASHP for its program. States that have mandated accreditation range from North Dakota to Wyoming.

Even PBMs may be facing accreditation. URAC, an independent accrediting organization, has formed a committee to study the creation of requirements for the first-ever accreditation programs addressing pharmacy benefit management. The goal is to provide oversight of PBMs to make sure they deliver on their promises of customer service and reduced pricing. URAC hopes to roll out its accreditation program next year.

As these examples show, like it or not, accreditation is expanding from acute care to other healthcare settings, so get ready for it.