May 22, 2012

Utilization Review Accreditation Commission [URAC]

URAC was originally incorporated under the name "Utilization Review Accreditation Commission," however that name was shortened to just the acronym "URAC" in 1996 when it began accrediting organizations such as health plans and preferred provider organizations. URAC offers 15 accreditation programs, the most common for MBHOs being Core Accreditation and Health Utilization Management Accreditation. Core Accreditation standards are the foundation of URAC accreditation, and include organizational structure, staff qualifications, training and management, oversight of delegated activities, quality management and consumer protection. URAC Health Utilization Management Accreditation standards ensure that MBHO follow clinically sound UM processes, respect patients' and providers' rights, maintain confidentiality, give payers reasonable guidelines, and are compatible with the 2002 U.S. Department of Labor claims regulations.

Joint Commission on Accreditations of Healthcare Organizations

The Joint Commission on Accreditations of Healthcare Organizations (JCAHO) originated as the accrediting body for hospitals, but JCAHO has been active in behavioral health care accreditation since 1972. It started offering specialized accreditation services to managed behavioral health plans and integrated delivery systems in 1994. Currently, JCAHO accredits more than 1,600 behavioral health care organizations and more than 25 behavioral health plans/integrated delivery systems. To be eligible for a JCAHO accreditation survey, a behavioral health plan or integrated system must provide for health care services to a defined population of individuals, offer comprehensive and/or specialty services, and have both a centralized, integrated structure and contract with, or manage, actual care delivery sites, which include practitioner offices and/or components that deliver care


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