URAC’s Health Plan with Health Insurance Marketplace Accreditation is specifically recognized by the Department of Health and Human Services (HHS) as an accreditation that Qualified Health Plans (QHPs) on the Health Insurance Marketplace must achieve. URAC is eligible to accredit issuers of Marketplace QHPs in all 50 states and the District of Columbia.
URAC accreditation signifies an issuer has undergone and passed a rigorous and independent review of every aspect of its operation, including the quality of care and level of service provided to enrollees. Understanding the value of integrated care, URAC also weaves key behavioral health components into our Health Plan with Health Insurance Marketplace standards.
Organizations that achieve this accreditation have demonstrated their quality practices and compliance with standards and measures that align with state and federal requirements for value-based healthcare. These organizations are subject to additional federal requirements, in addition to all requirements of the Health Plan Accreditation program.
All Qualified Health Plans (QHPs) must have an independent third party review their measure results as required by the government. Data validation vendor selection should meet the requirements cited by the government.