Pharmacy Benefits Manager OptumRX requires VAWD accreditation


Pharmacy Benefit Manager (PBM) OptumRx announced this month that effective Oct. 1, it will only accept billed claims for products purchased from a Verified-Accredited Wholesale Distributor (VAWD).

The National Association of Boards of Pharmacy VAWD program is an accreditation for pharmaceutical wholesale distribution facilities designed to ensure compliance with state and federal laws and VAWD criteria.

The letter states that pharmacies “MUST purchase ALL medications dispensed for claims being dispensed to OptumRX participants†from a VAWD Accredited distributor.

Wholesale distributors that display the VAWD seal as part of their accreditation have undergone a criteria compliance review, including a rigorous review of their operating policies and procedures, licensure verification, survey of facility and operations, background checks, and screening through the NABP Clearinghouse. Accredited facilities are reviewed annually and undergo a site survey every three years, according to the NAPB.

VAWD was developed in response to the Food and Drug Administration’s Counterfeit Drug Task Force findings and recommendation that NABP update its Model Rules for the Licensure of Wholesale Distributors.

VAWD identifies legitimate and legally operating wholesale distributors and verifies compliance with state and federal laws for wholesale distribution. The idea is to help protect the public from counterfeit drugs. Accredited facilities are reviewed annually and undergo a site survey every three years.

Compounding wholesale distributors must be VAWD-accredited to be licensed and to be able to ship into certain states. This licensing requirement is considered even more stringent than those of some states. Indiana, North Dakota, and Wyoming require VAWD accreditation as a requirement for licensure. Many other states have passed legislation or regulations that recognize VAWD or third-party accreditation and/or inspection.

Although OptumRx is the first PBM that we are aware of to require this accreditation, others may follow.

The accreditation process can be lengthy and time consuming. The Health Law Offices of Anthony C. Vitale can assist your pharmacy business with acquiring the necessary accreditation. If you have any questions or concerns, feel free to contact The Health Law Offices of Anthony C. Vitale at 305-358-4500 or email us at info@vitalehealthlaw.com.

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