The Basics

CM 10 requires that the organization implement P&Ps to protect both consumers and its own case managers (employees and delegates).  This could be housed all in one P&P, or in a variety of P&Ps, so make sure you're familiar with all of your organization's P&Ps that deal with the safety of consumers and employees.

Management Tips

Those P&Ps should be broad in scope, providing consumers not only with legally mandated protections (e.g., workers compensation, informed consent, and disability rights laws), but also mechanisms to help prevent of suicide, violence violence, and infectious diseases.  The protections against violence and disease should extend to case managers.

The P&Ps also should provide mechanisms to help consumers get answers to their legal and benefits questions, and to report abuse and unusual events.  

If your organization doesn't have field case managers, of course you won't need P&Ps to protect them against infectuous diseases in the field.  That subsection would be "N/A" with only in-house case managers.  Similarly, requirement of consumer protection through compliance with workers' compensation laws applies only to CMOs that operate in the workers' compensation world.  

URAC Accreditation Tips

This is a P&P-driven standard, so make sure you go down the check-list URAC provides in the program guide to assure that your P&Ps cover every one of the bulleted points.  In addition to those P&Ps, you'll also want to submit a sample incident report for the desktop review.

The onsite review for this standard will be focused on the case manager interviews.  The Reviewer is likely to pose hypothetical questions to case managers on any or all of the points covered in the P&Ps you submit to AccreditNet to make sure they've been properly trained in those P&Ps and are capable of implementing them.