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:5/28/2016)... ... 28, 2016 , ... May 26, 2016- In search of the K. Warriors, ... event of “K Warriors” on June 4, 2016 at Ashbury Hotel and Suites 600 ... sponsored and hosted by Shaolin Institute and sanctioned by KSF (Kungfu Sanda Federation), This ...
(Date:5/28/2016)... , ... May 28, 2016 , ... In a part of the city where’s it’s ... new farm-to-table Kelowna restaurants is hoping to attract diners with a taste for ... Suites officially opened the doors to Cornerstone Grill, an urban casual restaurant focusing on ...
(Date:5/27/2016)... ... May 27, 2016 , ... Southland Log Homes , designer ... timber frame barn kits, which can be found on its website at SouthlandLogHomes.com. , ... barn plans, and they highlight the craftsmanship of timber post and beam construction. ...
(Date:5/27/2016)... ... May 27, 2016 , ... W.S. Badger Co. ... today that it has been recognized as one of the best small businesses for ... named as one of nine small businesses providing progressive benefits to new parents on ...
(Date:5/27/2016)... ... May 27, 2016 , ... With over 60 percent ... the demand for a sustainable product to aid in the rehabilitation process has steadily ... the recovery of individuals with hemiplegia due to stroke. , Ekso Bionics has now ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... SPRINGS, Florida , May 25, 2016 ... Business Conference & Expo earlier this month, the numbers ... As revenues continue to climb into the billions, more ... the newly released 4th Edition State of Legal Marijuana ... Frontier, a cannabis-focused data-analysis firm, much of the increase ...
(Date:5/25/2016)... , May 25, 2016 Digital Health ... to it by the US Patent and Trademark ... technology includes proprietary processes for electronic opt-­in and ... and wellness programs, HIPAA compliance and otherwise. ... "Our technology allows for ...
(Date:5/25/2016)... , May 25, 2016 ... the precision of circulating tumour DNA (ctDNA) analysis ... the appointment of Professor Clive Morris ... leadership across the clinical development programme, scientific collaborations, ... help deliver significant improvements in clinical outcomes for ...
Breaking Medicine Technology: