Arete Healthcare Solutions

​          URAC accreditation guidance

Are you ready for the new WCUM requirements in California?

In October of 2016, California Governor Jerry Brown signed into law SB 1160, which requires utilization management organizations that provide workers' compensation to be URAC-accredited.

According to the URAC press release, California's workers' compensation fraud is estimated to range between $1 and $3 billion, and "[i]n 2014, California had the highest worker’s compensation premiums in the nation – 188 percent over the median." This new law is meant to cut down on fraud and boost efficiency within utilization management organizations.

URAC is the gold standard for healthcare organization accreditation, and now workers' compensation utilization management programs accredited through URAC can be prepared to address risks to patient safety, comply with federal and state law, have an unbiased structure by which to determine medical necessity, and more.

Workers' Compensation Utilization Management programs in California must be accredited through URAC by July 2018.

Let an experienced consultant guide you through the accreditation process. We can take you through each step of the process, from 
document development and gap analysis to training on what the law requires.

Get in touch with Arete today to learn more about what your Workers' Compensation Utilization Review program needs to meet this new state regulation.

The URAC-accredited Workers’ Compensation Utilization Management program: WCUM urac accreditation

  • Employs drug utilization management mechanisms to address therapeutic appropriateness, over and underutilization, dosage, duration of treatment, duplication, drug allergies, and more
  • Provides an independent, unbiased determination of medical necessity beginning with an initial clinical review, then moving to a peer clinical review if needed
  • Is prepared to address any risk to patient safety, such as contraindicated treatments, adverse drug interactions, or inappropriate treatment, during the review process
  • Adheres to time frames outlined in the standards for urgent and non-urgent review determinations
  • Understands and adheres to applicable state and federal regulations for Workers’ Compensation programs
  • And more.

​​Source: -

"Workers' Compensation Health Utilization Management and Workers' Compensation URAC Accreditation (HUM/WCUM)

Utilization Management Accreditation" urac accreditation

Workers' Compensation WCUM urac accreditation

Utilization Management Health Utilization Management and Workers' Compensation URAC Accreditation (HUM/WCUM)Type your paragraph here.

100% URAC Accreditation Success Rate! Let an experienced consultant guide you through the accreditation process for Health Utilization Management and Workers' Compensation URAC Accreditation (HUM/WCUM)

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