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URAC Urges CMS to Leverage Existing Quality Efforts for Medicare Advantage Contracting

Tuesday, August 30th, 2016

Washington, D.C. – In public comments submitted to the Centers for Medicare and Medicaid Services (CMS) on proposed revisions to payment policies under the Medicare Physician Fee Schedule for CY2017, URAC urged building on the quality efforts of existing independent, national accreditors if the federal agency begins requiring providers and suppliers to enroll with Medicare as a prerequisite to Medicare Advantage contracting.

TH PDF graphicThe agency proposed requiring that all providers and suppliers be screened and enrolled in Medicare in order to contract with a Medicare Advantage organization. URAC recognizes the agency’s desire to protect the integrity of Medicare and the need to protect enrollees from unnecessary or inadequate services. URAC encouraged CMS, should they choose to move forward on the proposed enrollment requirement, to leverage the quality efforts already underway by accrediting organizations.

“If CMS chooses to require enrollment,” URAC’s comment stated, “CMS should consider emulating its past use of accreditation to augment its oversight of health care functions to assure patients receive quality care.”
URAC noted that CMS has recognized or proposed recognition of the independent accreditation of URAC and other accreditors in programs such as Medicare Advantage Plan Deeming, Qualified Health Plans operating on Health Insurance Marketplaces, and the proposed Merit-Based Incentive Payment System (MIPS).

“URAC stands ready to work with CMS to leverage existing quality standards in a manner that allows CMS to achieve its goals while limiting the administrative burden placed on providers and suppliers,” URAC President and CEO Kylanne Green said in the submitted comments.

URAC also applauded CMS’s “continued efforts to reimburse physicians and clinicians in a manner that reflects the current practice of medicine without dictating change through payment,” adding URAC’s belief that CMS’s recognition of the role and use of telehealth is crucial to the continued use of telehealth/telemedicine as a tool to deliver care in a manner that assures the same quality of care as through face-to-face interactions.

Please contact URAC at info@urac.org, or call (202) 216-9010 with specific questions. To learn more about URAC and its accreditation programs, go to urac.org.


About URAC

Founded in 1990, URAC is the independent leader in promoting health care quality through accreditation, certification, and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of health care. Our portfolio of accreditation and certification programs span the health care industry, addressing health care management, health care operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to show¬case their validated commitment to quality and accountability.

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