Our journey in leading the way to exceptional health care for all
Utilization Review Accreditation Commission incorporated
Significant legislation in Maryland sought to eliminate health plans’ ability to conduct utilization review. Health plans saw the need to develop standards and update as needed. At this time, other accrediting bodies did not address utilization review. This is why URAC was born.
URAC develops country’s first Health Utilization Review Standards
URAC set the standards nationally to meet the pressing need of health plans to conduct utilization review.
URAC releases Health Utilization Management Standards
Broader in nature, these standards include a foundational focus on business functions and quality management oversight including operations infrastructure and risk management.
Company officially becomes URAC
This name change was in response to the expanded scope of accreditations offered by the Utilization Review Accreditation Commission and the types of organizations who could earn them, such as health plans, provider organizations and pharmacies.
Health Insurance Portability and Accountability Act (HIPAA) signed into law
In addition to other benefits, HIPAA made health care organizations accountable for keeping patient health data private and confidential.
Balanced Budget Act signed into law creating State Children’s Health Insurance Program (CHIP) and expanding Medicare Advantage
CHIP sought to provide more than 10 million children with health insurance, while Medicare Advantage updated and improved the choice of plans for beneficiaries.
URAC releases country’s first Case Management Accreditation
As an outgrowth of utilization management, case management became a critical need to help manage patients who have medically complex cases. Part of the need stemmed from managing costs and part to ensure these patients receive better care and outcomes.
URAC publishes Health Network Accreditation*
*At the time, “health network” was the appropriate terminology when talking about “health plans.”
URAC distinguishes unique group needs by updating Health Plan Health Network standards
Recognizing the unique need of non-plan types of health networks such as preferred provider organization (PPO) and independent physician association (IPA) programs, URAC created two different groups and standards: Health Plan and Health Network.
Medicare Part D signed into law
This drug coverage was created to protect the sickest patients from high drug costs, as well as provide the benefit to a greater body of patients with lower drug costs.
URAC releases first-in-the-nation Health Website Accreditation
Observing that many people get their health information online, URAC created a distinction between websites that provide sound information and those that don’t. This accreditation provides a “seal of approval” to help patients recognize the validity of the content. Our website accreditation continues to be a sign of quality health websites today.
URAC launches AccreditNet, our online application portal
As the digital age progresses, URAC develops the technology to accept applications and associated materials online.
URAC Becomes CMS Certified with Deemed Status for Medicare Advantage Organization Accreditation
The CMS deemed status affirms that a national health care accreditation organization exceeds expectations in a particular area of expertise.
URAC releases country’s first Pharmacy Benefit Management (PBM) Accreditation
Continuing its tradition of innovation, URAC sees the specialized need for medication management accreditations.
URAC expands its pharmacy accreditation program to include Specialty Pharmacy and Mail Service Pharmacy, as well as Workers’ Compensation, and Property and Casualty PBM
As URAC seeks to provide exceptional care for all, it develops distinctive programs to meet all growing needs.
Patient Protection and Affordable Care Act (ACA) signed into law
This law provides various rights and protections to patients. The intention is to make health coverage more fair and affordable.
URAC’s Health Plan Accreditation receives CMS Deemed Status for exchange marketplaces
Once again, URAC receives prestigious recognition – this time for its expertise in health plan accreditations.
URAC releases Patient Centered Medical Home Achievement*
*This achievement, later evolving into a certification, marks URAC’s first physician program. Previously, accreditations focused on organizations. However, URAC saw the need to recognize providers who deliver timely care and improve patient access.
URAC releases first-in-industry Clinical Integration Accreditation
These standards for physician practices help them clinically integrate their systems to access key data.
URAC offers Accountable Care Accreditation
Recognizing the establishment of accountable care organizations (ACO), URAC develops these standards to meet their unique needs.
Medicare Access and CHIP Reauthorization Act (MACRA) signed into law
This act leverages ACOs to provide this care.
URAC releases its first telehealth accreditation, then called Accreditation Program for Online Patient Consultations
To support care outside the traditional walls of hospitals and doctor’s offices, URAC sets the standard for telehealth services.
CMS recognizes URAC’s Patient Centered Medical Home Certification for MACRA Compliance
This recognition demonstrates URAC’s commitment to setting the highest standards.
21st Century Cures Act signed into law
This law is designed to help accelerate medical product development and bring the latest medical advances to the patients who need them more efficiently.
URAC becomes physician-led as Shawn Griffin, MD, joins as president and CEO
Dr. Griffin pushes URAC to live its mission in “leading the way to exceptional health care for all.”
URAC unveils new employee-chosen tagline to celebrate its 30-year anniversary
“30 Years of Setting the Standard in Health Care” sets the stage for the next 30 years of excellence.
URAC launches Mental Health Parity Manager Compliance Tool and industry’s first Mental Health Parity Accreditation
URAC provides a clear path for health plans to determine if they are offering mental health benefits on par with their other health care benefits.
URAC receives CMS deemed status for Home Infusion Therapy Accreditation
This recognition further supports URAC’s high standards for pharmacy programs.
URAC launches country’s first Remote Patient Monitoring Accreditation
As an integral part of telehealth, URAC develops this program for companies who specialize in remote patient monitoring.
URAC releases updated standards for Telehealth Accreditation
To further improve the care delivered through telehealth, URAC revises its standards, using experiences learned through COVID-19.
URAC launches international accreditations, beginning with telehealth
Aiming to improve health care around the world, URAC commences its international accreditation program.
Sep 23, 2021
Launch of URAC’s Specialty Physician Practice Dispensing Accreditation
This recognition further supports URAC’s high standards for pharmacy programs and support for better patient outcomes.
Oct 5, 2021
Launch of URAC’s Client Portal
URAC develops a Client Portal to assist clients with the accreditation/certification process, provide tips for reaccreditation/recertification, and to be a go-to resource for news and updates from URAC.
Nov, 17, 2021
URAC launches Health Plan 8.0
URAC launches Health Plan 8.0 that addresses the needs of health plans by streamlining our standards to shorten the timeline, and also;
- Allows health plans to be in the driver’s seat to establish their own metrics and performance monitoring so they are meaningful to the plan’s goals.
- Introduces contemporary concepts about artificial intelligence, machine learning and regulatory requirements regarding network management.
- Addresses mental health parity, which is increasingly important and enforced by individual states and the Federal Department of Labor.
And can be paired with a new, optional Long-Term Services and Supports module for organizations that want to demonstrate their expertise in the broad range of service provided to those with long-term care needs.
May, 2, 2022
URAC launches Pharmacy Service 1.0
URAC launches Pharmacy Services 1.0 to include those services offered by a pharmacy or pharmacist outside of traditional dispensing services.
The onset of the COVID pandemic shed light on the accessibility and critical role that pharmacists play in community practice. In many respects, COVID pushed the boundaries of care. Additionally, with the growth of pharmacy-based clinics and health hubs, pharmacies now serve more patients within the walls of what was once simply a site for dispensing medications.
With that in mind, URAC developed its Pharmacy Services Accreditation as an independent third-party validation of pharmacy services being provided throughout the community. Pharmacy Services Accreditation positions organizations to demonstrate their commitment to promoting services that ensure quality of patient care.
2022 and beyond
URAC continues to watch legislation, laws, regulations and technology development – and their impact on health care – to ensure it's providing the highest standards in quality care and safety.