URAC Seeking Public Comment on Revisions to Health Plan Suite of Programs

Public Input Sought at http://www.urac.org/publiccomment/ until February 14, 2011

WASHINGTON, Dec. 31, 2010 /PRNewswire-USNewswire/ -- URAC today announced a call for public comment on proposed changes to its Health Plan Standards, Version 7.0, Health Network Standards, Version 7.0, Provider Credentialing Standards, Version 6.0, Health Utilization Management Standards, Version 7.0, and Workers' Compensation Utilization Management Standards, Version 6.0, as well as an initial draft of Health Insurance Exchange Standards, Version 1.0.

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Purchasers, policy makers, consumers, health care management organizations, employers, and health plans are encouraged to provide their comments on the proposed URAC standards at http://www.urac.org/publiccomment/.  The deadline for public comment is February 14, 2011.

URAC is committed to keeping its standards current with changes to regulatory and industry benchmarks. The proposed changes to the standards have been made in light of health care reform, and in particular the Patient Protection and Affordable Care Act (PPACA) Part 2: Consumer choices and insurance competition through health benefit exchanges, Sec. 1311: Affordable choices of health benefit plans, as well as Medical Loss Ratio (MLR) and Mental Health Parity regulations.  There will be a separate public comment period starting at the end of January 2011 for measures, which will be incorporated into the Health Plan, Health Network and Health Utilization Management accreditation programs.

"URAC is dedicated to responding to the dynamic health care system by continuously improving its Standards," said Alan P. Spielman, President and CEO of URAC.  "These revisions will help provide clarity and consistency for organizations within this changing regulatory framework."

Public comment is sought on revisions to URAC's current accreditation products:

  • Health Plan, version 7.0
  • Health Network, version 7.0
  • Provider Credentialing, version 6.0
  • Health Utilization Management, version 7.0
  • Workers' Compensation Utilization Management, version 6.0

URAC is also presenting an initial draft of Health Insurance Exchange Standards, Version 1.0 for public comment.  These standards are based upon Part 2, Section 1311 of PPACA, and will be modified pending final rules from the Department of Health and Human Services.

As part of this major revision to the standards, URAC expanded requirements for a health plan's patient information systems to include online enrollment and consumer assistance with benefit management.  The health plan must consider mental health parity when conducting various plan functions, including network and utilization management.  URAC is also requesting feedback on the prospect of including drug utilization management standards as part of its utilization management requirements for health plans and restructuring the standards according to the MLR Columns 1-5.

"Public comment is a critical component to the process of evaluating proposed enhancements and changes to Standards.  Every comment is carefully considered in the development process," said R. Douglas Metz, DC, EVP & Chief Health Services Officer, American Specialty Health and Chair of the Health Standards Review Committee.  "The URAC Health Standards Committee is supporting various initiatives to assess the URAC standards in light of the Patient Protection and Affordable Care Act and changes in the health care system. URAC standards are improved by the input of knowledgeable stakeholders."

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.