URAC Core 17 -- v. 2.1 Proposed Revision

URAC apparently believes (with good reason, in my view), that its current delegation standards are fine just as they are, and therefore proposes no changes in the heart of the four delegation standards, Core 17. This standard outlines the required elements of the contract of delegation between the accredited organization and the contractor:

The organization enters into written agreements with contractors that: (--)
(a) Specify those responsibilities delegated to the contractor and those retained by the organization; (Wt = 2)
(b) Require that services be performed in accordance with the organization's requirements and URAC standards; (Wt = M)
(c) Require notification to the organization of any material change in the contractor’s performance of delegated functions; (Wt = 4)
(d) Specify that the organization may conduct surveys of the contractor, as needed; (Wt = 2)
(e) Require that the contractor submit periodic reports to the organization regarding the performance of its delegated responsibilities; (Wt = 3)
(f) Specify recourse and/or sanctions if the contractor does not make corrections to identified problems within a specified period; (Wt = 2)
(g) Specify the circumstances under which activities may be further delegated by the contractor, including any requirements for obtaining permission from the organization before any further delegation; and (Wt = 4)
(h) Specify that, if the contractor further delegates organizational functions, those functions shall be subject to the terms of the written agreement between the contractor and the organization and in accordance with URAC standards. (Wt = M)

Substantively, the only changes brought about by the scoring system change (other than the fact that the multitude of elements to this standard inevitably gives it morerelative importance than it has in the current system) have to do with which elements are now mandatory. In this regard, there was a major reshuffling of priorities. In the current version the current mandatory elements (I consider any "primary" element in a standard weighted "5" mandatory) are subsections (a), (b), (c), (f), and (g). The proposed revision would make only subsections (b) and (h) mandatory. The transformation of (h) into a mandatory standard should be noted by the contracting department, as this is a frequently missed elements not only by first-time applicants, but by some reaccreditation veterans, as well.

Finally, URAC proposes to help applicants with the following addition to the Interpretive Information:

Examples of “material change” in Core 17(c) for the delegated entity include a change of address, loss or replacement of the senior clinical staff person, and prolonged interruption of services due to any cause (e.g., natural disaster, IT systems down, decrease in staffing, substantive change in delegated processes, etc.)

This is useful, in our view, as a number of our clients have expressed puzzlement about what this clause was intended to address.