Medicare Advantage Accreditation

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The Centers for Medicare and Medicaid Service’s (CMS’s) deeming program allows Medicare Advantage (MA) organizations to satisfy certain federal requirements by earning accreditation from an approved accrediting organization. This program allows MA organizations to earn “deemed” status for CMS requirements in the permitted domains, thus avoiding a full CMS audit.

URAC was approved as a CMS-approved accreditation organization for MA deeming of HMOs/PPOs in 2012 for a six-year term. CMS has renewed URAC’s status as an approved accreditor for MA plans, granting URAC “deeming authority” for a new six-year term, through June 2, 2025.

URAC clients benefit from our unique accreditation process, which facilitates learning and helps the organization create a framework for continuous improvement. In addition, URAC’s MA program features a simplified accreditation process, focused standards, reduced compliance burden, and affordable pricing.

The URAC-accredited organization meets CMS Medicare Advantage regulatory standards in the following areas:

  • Quality improvement

  • Anti-discrimination

  • Confidentiality and Accuracy of Enrollee Records

  • Information on Advance Directives

  • Provider Participation Rules

Who may apply?

Health plans, including Health Maintenance Organizations and Preferred Provider Organizations.

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