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URAC Announces Revised Standards for Five Accreditation Programs

Tuesday, October 11th, 2011

Washington, D.C. – October 11, 2011 – URAC, a leading health care accreditation and education organization, announced revisions to five (5) of its Health Care Management and Operations Accreditation programs. These revisions, which are part of URAC’s commitment to regular comprehensive review of its standards, have been approved by the URAC Board of Directors and will be released in November 2011.

The revisions to the standards have been made in light of health care reform, addressing the goals of the Patient Protection and Affordable Care Act (PPACA) Part 2: Consumer choices and insurance competition through health benefit exchanges, Sec. 1311: Affordable choices of health benefit plans, and as such address Medical Loss Ratio (MLR) and Mental Health Parity regulations.

The program revisions approved by the Board include:

  • Health Network, v7.0
  • Provider Credentialing, v6.0
  • Health Utilization Management, v7.0
  • Workers’ Compensation Utilization Management, v6.0
  • Health Plan, v7.0 (previously announced

URAC’s Health Network standards have been revised to elaborate on the provider relations program, and to provide clarification on the credentialing phase-in process for Health Networks. Additionally, these standards as well as the Provider Credentialing standards now allow for delegation oversight of the credentialing process to occur remotely. Further revisions to the Provider Credentialing program increased patient protection by requiring procedures that prevent a provider from being listed in a provider directory prior to being credentialed. Requirements for primary source verification of licensure were also clarified.

Two new standards have been incorporated into URAC’s Health Utilization Management and Workers’ Compensation Utilization Management programs. The first, Prospective Review Patient Safety, meets the criteria for a quality improvement activity per Medical Loss Ratio regulations. The second, Reviewer Attestation Regarding Credentials and Knowledge, ensures that a reviewer has the requisite background and experience to conduct the review.

Publication of the revised standards, including the accreditation guides and crosswalks to previous versions, will be available in November 2011.

For more information about these revised standards please contact business.development@urac.org or go to http://www.urac.org.

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For 25 years, URAC has been the independent leader in promoting health care quality through accreditation, education, and measurement. URAC offers a wide range of quality benchmarking programs that reflect the latest changes in health care and provide a symbol of excellence for organizations to showcase their validated commitment to quality and accountability. URAC’s evidence-based measures and standards are developed through inclusive engagement with a broad range of stakeholders committed to improving the quality of health care.

For more information about URAC, contact us.

Interested in accreditation?
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