Independent Review Organizations

 In revising the Independent Review Organization standards from v. 3.0 to v. 3.1, URAC has modified the stem of IR 4, the mandatory standard dealing with reviewer credentialing.  In version 3.0, the stem read:

The organization establishes and implements selection criteria for reviewers, and implements a program to verify, and re-verify at least every three years, the qualifications of all reviewers.

Version 3.1 modify that stem to read as follows:

The organization establishes and implements selection criteria for reviewers, and implements a program to verify current unrestricted credentials (prior to assignment of any reviews), and re-verify at least every three years, the qualifications of all reviewers.

Obviously, the big change here is the requirement that the organization make sure that it has verified that a reviewer has current unrestricted credentials before it assigns that review or any reviews at all.  The best explanation for such a revision is that some applicants for accreditation had a program for verification that was not sufficiently rigorous, and, in fact, forwarded reviews to reviewers who had not gone through the credentials verification process.  This mandatory standard is now unambiguous in its prohibition of such a practice.

The revised version of the standard, in full, now reads:

The organization establishes and implements selection criteria for reviewers, and implements a program to verify current unrestricted credentials (prior to assignment of any reviews), and re-verify at least every three years, the qualifications of all reviewers.   At a minimum, such a program shall address: (Primary)

(a) Verification of professional credentials, including (Primary)

(i) Current licensure; (Primary)

(ii) Current board certification, if applicable; (Primary)

(iii) History of sanctions and/or disciplinary actions; and (Primary)

(iv) Professional experience; (Primary)

(b) Potential conflicts of interest. (Primary)