URAC Invites Public Comment for Medicaid Health Plan Accreditation Standards

Stethoscope on pile of dollar bills. Medicaid concept.

WASHINGTON – Independent healthcare accreditor URAC will open a public comment period for proposed Medicaid Health Plan Standards beginning on June 25, 2019, and ending July 15, 2019, at 8 p.m. Eastern Time. Click here to access the proposed Medicaid Health Plan Standards and the tool for providing public comment: http://standards.urac.commentinput.com/?id=pdjha

“Everything we do – every standard we promote – seeks to improve the quality of healthcare delivered to patients. The pursuit of public comment on proposed standards is a critical and valuable function of the URAC standards development process,” says Shawn Griffin, MD, URAC President and CEO. “Each comment is carefully reviewed and considered before final approval. While a careful review of pertinent CMS regulations and the current literature informs these proposed standards, additional input from stakeholders is important prior to publication and launch.”

Program standards for Medicaid Health Plan are organized into nine focus areas:

  1. Foundational Requirements
  2. Delegation
  3. Compliance
  4. Credentialing
  5. Utilization Management
  6. Member Relations
  7. Network Management
  8. Operations and Infrastructure
  9. Quality Management

The proposed Medicaid Health Plan standards are closely aligned with pertinent language in CMS regulations C.F.R. §431, 438, 456, and 489. Foundational requirements include: regulatory compliance, senior clinical staff responsibilities, consumer complaints, health literacy, and maintaining and complying with policies. All organizations offering Medicaid plans to beneficiaries in one or more states will be eligible to apply for this URAC recognition.

For more information about URAC’s Medicaid Health Plan standards, contact URAC Product Development Principal Deborah Smith at 202-962-8802 or send an email to: Program_Standards_and_Maintenance@urac.onmicrosoft.com.


About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. URAC is a nonprofit organization using evidence-based measures and developing standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.  For more information, visit www.urac.org.


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