Last updated: April 2026
URAC Health Plan with LTSS Accreditation Consulting — Integral Healthcare Solutions
URAC Health Plan with Long-Term Services and Supports (LTSS) Accreditation is a comprehensive third-party validation for health plans that serve members requiring ongoing personal care, home- and community-based services, or institutional long-term care. IHS guides health plans through every phase of URAC Health Plan with LTSS Accreditation — from initial gap analysis through final survey and accreditation decision. Every engagement is principal-led by Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC.
Who Needs URAC Health Plan with LTSS Accreditation
This accreditation is designed for health plans that manage or coordinate long-term services and supports for their members — specifically those who need assistance with daily self-care tasks due to aging, chronic illness, or disability. Organizations that typically pursue this accreditation include:
- Medicaid managed care organizations (MCOs) administering LTSS benefits under state contracts, where accreditation is required or strongly preferred by state agencies
- Dual-eligible (Medicare-Medicaid) plans that coordinate acute, behavioral, and long-term care across payer boundaries
- Commercial health plans with long-term care or home health benefit lines seeking to demonstrate quality to employer and government purchasers
- Integrated managed care plans that bundle physical health, behavioral health, and LTSS under a single benefit structure
- Health plans entering new Medicaid LTSS contracts where accreditation satisfies state quality requirements or reduces the burden of state annual compliance reviews
URAC offers this program as a standalone accreditation or as an add-on module to URAC Health Plan Accreditation, Medicaid Health Plan Accreditation, or Medicaid Health Plan with LTSS Accreditation — allowing organizations to structure their accreditation portfolio to match their specific lines of business.
What the Standards Cover
URAC Health Plan with LTSS Accreditation v8.0 integrates the core Health Plan standards with an LTSS-specific module. The combined framework addresses the full operating environment of a health plan serving LTSS populations:
Core Health Plan Standards
- Organizational Structure and Governance — leadership accountability, compliance program, delegation oversight
- Consumer Protection — member rights, grievance and appeals processes, notice requirements
- Quality Management — QM program structure, HEDIS/performance measurement, population health oversight
- Network Management — network adequacy, credentialing of LTSS providers, access standards
- Utilization Management — prior authorization processes, clinical criteria, UM decision-making
- Health Information and Privacy — data governance, security controls, member information management
LTSS Module Standards
- LTSS Program Structure (LTSS 1-3) — dedicated LTSS program design, leadership, and operational resources
- Comprehensive Assessment (LTSS 4) — functional assessment, medication review, member input, identification of available community resources
- Person-Centered Care Planning (LTSS 5) — individualized care plan development, member and caregiver participation, care plan features, ongoing care plan management
- Care Coordination (LTSS 4-5) — assessing coordination needs, warm handoffs, transition management, community linkages
- LTSS Quality Management (LTSS 6) — LTSS-specific quality metrics, outcomes tracking, continuous improvement tied to LTSS population data
The 2025-2026 update to the URAC Health Plan with LTSS program reduced application document uploads by more than 50%, streamlining the submission process without reducing the rigor of the underlying standards.
IHS Engagement Process
IHS operates as a structured consulting partner across the full accreditation lifecycle. Our standard engagement phases:
Phase 1 — Readiness Assessment and Gap Analysis
We map your current policies, procedures, delegated agreements, and operational workflows against every applicable URAC standard — both core Health Plan and LTSS module. We identify gaps, prioritize remediation by risk level, and deliver a written gap analysis report with a standards-by-standards status matrix.
Phase 2 — Policy and Program Development
Where gaps require new or revised documentation, IHS develops compliant policies, procedures, and program descriptions. For LTSS specifically, this often includes person-centered assessment tools, care plan templates, care coordination workflows, and LTSS-specific QM measures. All documents are drafted to URAC's required format and organizational standards.
Phase 3 — Evidence Building and Operational Track
URAC evaluates operational evidence — not just written policies. We work with your team to build an evidence library: logs, case files, committee minutes, delegation monitoring reports, and QM dashboards that demonstrate consistent implementation. We advise on the operational track record period required to support your submission.
Phase 4 — Application Preparation and Desktop Review
IHS prepares and quality-reviews your URAC application package. We manage the document upload process and coordinate responses during URAC's desktop review — typically 30–45 days, with rounds of revisions. Our familiarity with URAC's reviewer expectations reduces revision cycles significantly.
Phase 5 — Interview Preparation and Survey Support
URAC surveyors conduct structured interviews with organizational leaders and operational staff. IHS prepares your team through mock interviews, staff briefings, and scenario walkthroughs aligned to the LTSS module standards. We support you through the onsite or virtual survey and remain available through the Accreditation Committee decision.
Phase 6 — Post-Survey RFI and Remediation (if needed)
If URAC issues a Request for Information (RFI) following the survey, IHS manages the full response — drafting corrective documentation, marshaling evidence, and preparing the written submission within URAC's deadline.
Why IHS
- Unmatched URAC institutional knowledge. Thomas G. Goddard, JD, PhD served as Chief Operating Officer and General Counsel of URAC — the organization that writes these standards. No consulting firm has deeper familiarity with how URAC standards are interpreted, applied, and evaluated.
- Principal-led every engagement. You work directly with Thomas G. Goddard, JD, PhD — not a junior associate. Every gap analysis, every policy review, every interview prep session is conducted at the principal level.
- LTSS-specific operational expertise. LTSS accreditation requires more than health plan compliance knowledge — it requires understanding of community-based services, person-centered planning frameworks, and the regulatory overlay of state Medicaid LTSS contracts. IHS has guided organizations through this intersection.
- Efficient, not padded. URAC's 2025-2026 updates streamlined the application process. IHS structures engagements to match — no unnecessary deliverables, no redundant documentation rounds.
- Full-cycle coverage. From the first gap analysis through the final accreditation seal, IHS covers every stage. You do not need to piece together multiple vendors for application support, survey prep, and RFI response.
URAC Fees
URAC does not publicly disclose its fee schedule. Contact URAC directly at businessdevelopment@urac.org for current application and accreditation fees applicable to your organization's size and structure.
IHS consulting engagement fees are scoped per engagement — contact us for a proposal tailored to your organization's starting point, timeline, and scope.
Ready to Start
URAC Health Plan with LTSS Accreditation typically requires 12–18 months from decision to award. Organizations that engage a consultant at the outset — rather than after discovering gaps late — consistently have shorter timelines and fewer post-survey remediation cycles. The earlier you begin, the more runway you have to build the operational track record URAC requires.