URAC Core 11 -- v. 2.1 Proposed Revision

URAC's proposed changes to Core 11, which focuses on the responsibilities of the senior clinical staff member, are worth noting.  The changes are both substantive and in terms of scoring.  The new standard would read:

A senior clinical staff person: (--)
(a) Provides guidance for all clinical aspects of program; (Wt=3)
(b) Is responsible for clinical aspects of program; and (Wt=M)
(c) Has periodic consultation with practitioners in the field. (Wt=3)
(d) Ensures that the organization has qualified clinicians accountable to the organization for decisions affecting consumers. (Wt=M)

Substantive, subsection (d) is new. URAC explains this change this way:  "Added element (d) to address the senior clinical staff person’s role. Senior clinical staff may or may not serve as a clinical decision-maker for the clinical areas covered by the organization’s services; therefore, the new standard element indicates that this individual “Ensures that the organization has qualified clinicians accountable to the organization for decisions affecting consumers."

While the change may seem subtle, the fact that it is a mandatory standard makes it less subtle.  Coupled with the other scoring change, making subsection (b) mandatory, too, shifts significantly more attention to this standard than in the current version.  Under this proposal, there would be two ways to flunk, whereas this standard could not, by itself in its current version, break a URAC applicant's heart.