Aside from providing general background information, such as ownership, licensure and employee information, LTC pharmacies must also attest to being an LTC pharmacy, which is often defined as a pharmacy that solely services LTC facilities, and must provide information regarding the pharmacy’s services. Specifically, some PBMs will request which and what type of LTC facilities the pharmacy services, the states the pharmacy is licensed in, and even which patients the pharmacy services. Further, PBMs will also inquire as to the pharmacy’s ability to meet performance and service criteria that are specific to LTC pharmacies. For example, such criteria may include (i) comprehensive inventory of drug products commonly used in LTC facilities, (ii) extensive pharmacy operations that allow for drug utilization reviews, monitoring of ordering and distribution of drug products to LTC facilities, and ongoing training of pharmacy staff members, (iii) special drug packaging, (iv) capacity to provide IV medications and access to home infusion drugs, (v) on-call pharmacist services, (vi) delivery services to LTC facilities, and (vii) emergency supplies of drug products, as required by the specific LTC facilities the pharmacy services. In addition to providing the above information through a questionnaire, the pharmacy can also expect the PBM to conduct an onsite audit. In most instances, a denial of admission will require the pharmacy to wait a year prior to re-applying for network access. As such, it is crucial for a pharmacy anticipating to undergo LTC pharmacy credentialing to ensure that it meets each PBM’s terms and conditions.
How Frier Levitt Can Help
If your LTC pharmacy is seeking PBM network access or you are looking to establish a LTC pharmacy, contact Frier Levitt to speak to an attorney today.
