Recent state legislative approaches to regulating utilization review reflect URAC national standards.
As state legislatures begin to regulate utilization review activities, some appear to be utilizing the URAC standards for guidance. Still others (e.g., Iowa, Nebraska, and New Hampshire) require URAC accreditation as a prerequisite for utilization review organizations to operate in their states, while others (e.g., Alabama, Arizona, Connecticut, Indiana, North Dakota, Tennessee, and Rhode Island) accept URAC accreditation in lieu of state certification. "States Look to Accreditation for Managed Care Seal of Approval," Medical Utilization Review, Vol. 22, No. 20, Oct. 27, 1994, at 7-8. The remarkable consistency between the 1994 URAC standards and the new California law are a hopeful sign that managed care decision-making will in the future be undertaken on a more uniform and objective basis. Only through this type of consensus building will the historical chasm between providers and payors be made smaller.
Reagan
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D002140:California; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence; D008329:Managed Care Programs / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D010820:Physicians / Q000331:legislation & jurisprudence; D011366:Professional Review Organizations; D013219:State Government; D014481:United States; D014600:Utilization Review / Q000331:legislation & jurisprudence*