January 31, 2018

PerformRx℠ receives NCQA Utilization Management Accreditation

Philadelphia, Pa. – PerformRx, a URAC-accredited, full-service pharmacy benefit manager (PBM) with industry-leading clinical programs and part of the AmeriHealth Caritas Family of Companies, is proud to announce it has achieved Utilization Management Accreditation from the National Committee for Quality Assurance (NCQA). NCQA Utilization Management Accreditation focuses on consumer protection and customer service improvement. NCQA 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. The accreditation is effective for two years.

“We’re delighted to receive this award, our first from NCQA,” said Mesfin Tegenu, M.S., R.Ph., president of PerformRx. “We are dedicated to quality and hold ourselves to the highest industry-recognized standards, including rigorous third-party measurement and validation of our performance. This recognition demonstrates our commitment to quality and speaks to the efficiency of PerformRx’s Utilization Management program and prior authorization platform, PerformPA®.[1]

“Achieving Utilization Management Accreditation from NCQA demonstrates that PerformRx has the systems, process and personnel in place to conduct utilization management in accordance the strictest quality standards,” said Margaret E. O’Kane, president, NCQA.

PerformRx fosters a clinical culture and has provided best-in-class services since 1999, including formulary development, drug therapy management, prior authorization, and rebate management. Its clients include Medicaid, Medicare, commercial, workers’ compensation, and employer group plans.


About PerformRx

PerformRx LLC is a URAC-accredited, next-generation pharmacy benefit manager (PBM) located in Philadelphia and part of the AmeriHealth Caritas Family of Companies. The company maintains a clinical culture, providing cost-effective therapies and extensive evidence-based programs at an optimal cost to its clients since 1999. PerformRx’s best-in-class pharmacy benefit management services include formulary development, drug therapy management and rebate management. PerformSpecialty® is PerformRx’s wholly-owned and integrated specialty pharmacy. The company’s business segments include Medicaid, Medicare, commercial and employer group plans. For more information, visit www.performrx.com.

About AmeriHealth Caritas

AmeriHealth Caritas is part of the Independence Health Group in partnership with Blue Cross Blue Shield of Michigan. AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. Operating in 17 states and the District of Columbia, AmeriHealth Caritas serves more than 5.6 million Medicaid, Medicare and Children’s Health Insurance Program (CHIP) members through its integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience serving low-income and chronically ill populations. For more information, visit www.amerihealthcaritas.com.

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.


[1] PerformPA® is an easy-to-use online pharmacy prior authorization (PA) tool designed to simplify and streamline the prior authorization process.