Navigation Links
URAC Open Public Comment Period for New Independent Review Organization Standards
Date:9/22/2009

Changes Reflect Provisions in NAIC Model Act

WASHINGTON, Sept. 22 /PRNewswire-USNewswire/ -- URAC, a leading health care accreditation and education organization, announced today that the public comment period is now open for proposed changes to its Independent Review Organization (IRO) Standards, Version 4.1. Purchasers, policy makers, consumers, health care management organizations, IROs, and health plans are encouraged to provide their comments on the proposed URAC standards now through November 6, 2009.

(Logo:http://www.newscom.com/cgi-bin/prnh/20030501/URACLOGO)

URAC is committed to keeping its standards current with changes to regulatory and industry benchmark. The proposed changes to the IRO standards are aligned with new provisions in the Uniform Health Carrier External Review Model Act (the Model Act), which the National Association of Insurance Commissioners (NAIC) adopted in June 2008. The Model Act is designed to provide a national standard and uniform approach for processing, conducting, and making external review determinations. One of the provisions of the Act incorporates accreditation to create a streamlined process for approving Independent Review Organizations.

"Independent Review Organizations (IROs) play an important role in consumer protection. Currently it is IROs and state laws that advocate for consumer protection of insurance coverage and outline how consumers can appeal in cases of denial of payment or service," said Doug Metz, DC, Chair of URAC's Health Standards Committee and Executive Vice President and Chief Health Services Officer for American Specialty Health. "By keeping its IRO standards aligned with the industry, URAC strives to provide a fair and impartial review process that benefits both patients and physicians with grievances."

Since September 14, 2009, three states have enacted legislation comparable to the Model Act. In two of those states, Connecticut and North Carolina, the regulations go into effect on October 1, 2009. In Idaho, the legislation is expected to go into effect on January 1, 2010. Illinois and Tennessee have similar legislation pending, which could pass before the end of the year.

"By providing IROs with accreditation standards, URAC helps ensure that services are free from conflicts of interest. The standards also establish qualifications for physician reviewers and address both medical necessity and experimental treatment issues," said Gib Smith, Executive Director of the National Association of Independent Review Organizations (NAIRO). "These benchmarks help guide consumers and providers, and ensure that everyone has a voice in the process."

"Because insurance regulations vary from state to state, there is a clear need for quality standards that would simplify the regulated application process and review requirements for Independent Review Organizations and External Review Organizations across different states," said Joyce Muller, President and CEO of IMEDECS, a NAIRO member organization. "By setting industry standards and promoting accountability and transparency, NAIC, NAIRO, and URAC all serve as role models and examples of how private organizations can offer leadership to coordinate complex regulations."

URAC's proposed new Independent Review Organization accreditation standards are available for review and comment at http://www.urac.org/publiccomment/. The deadline for public comment is November 6, 2009. After public comment, additional revisions will be made. Final standards could be approved by URAC's Board of Directors as early as December 2009.

About URAC

URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation, education and measurement programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, visit www.urac.org.


'/>"/>
SOURCE URAC
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Headache Publication Describes Potential Mechanistic Rationale for LEVADEX(TM) Favorable Adverse Event Profile
2. The Dr. Oz Show and the National Association of Free Clinics Host One Day Free Public Health Clinic at Houstons Reliant Convention Center on September 26
3. TeamStaff Receives Nasdaq Deficiency Notice Related to the Market Value of Its Publicly Held Shares
4. Public Option Still Viable As House Set to Pass It -- Not Fading, Says Robert Weiner, Former House Aging Committee Director
5. Long Term Care Seminars in Dayton, Cleveland, Cincinnati, and Columbus -- Free to Public
6. SXC Health Solutions announces pricing of upsized public offering of common shares
7. VIVUS Announces Pricing of Public Offering of Common Stock
8. J.D. Power and Associates Reports: Among Pharmacy Customers, Satisfaction is Equally as High for the Privately Insured and for Those With Public-Private Insurance
9. APA Offers Free Resources for Public on Mental Health Parity Law
10. Public Health, Faith Leaders Call on DC Council to Renew Funding for Successful Tobacco Prevention Programs
11. National Certification for Medical Interpreters - Public Call for Final Written Pilot Exam
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... June 25, 2016 , ... Experts from the American ... Annual Research Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. ... including advance care planning, healthcare costs and patient and family engagement. , AIR ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , ... Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. , ... our new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits ... terms of the latter, setting the bar too high can result in disappointment, perhaps ... slow progress toward their goal. , Research from PsychTests.com reveals that ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, ... at his family verbally and physically. , “When something upset him, he couldn’t control his ... it. He would throw rocks at my other children and say he was going to ...
(Date:6/24/2016)... ... ... Comfort Keepers® of San Diego, CA is excited to announce they are ... drive cancer patients to and from their cancer treatments. Comfort Keepers provides quality ... and ongoing independence. Getting to and from medical treatments is one of the ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 /PRNewswire/ ... Diabetes Tomorrow,s Leaders Scholarship is any indication, the future ... today online at www.diabetesscholars.org by the Diabetes ... stand in the way of academic and community service ... scholarship program since 2012, and continues to advocate for ...
(Date:6/23/2016)... June 23, 2016  Guerbet announced today that it ... Supplier Horizon Award . One of 12 ... recognized for its support of Premier members through exceptional ... excellence, and commitment to lower costs. ... recognition of our outstanding customer service from Premier," says ...
(Date:6/23/2016)... FRANKLIN, Tenn. , June 23, 2016 ... for automating, integrating and transforming the patient ... launch of several innovative new products and ... depth of its revenue cycle offerings. These ... establish more efficient workflows, remain compliant in ...
Breaking Medicine Technology: