ClearHealth Quality Institute President to Highlight National Symposium of Independent Medical Review Organizations

ClearHealth Quality InstituteTM (CHQI), a private health care accreditation body whose programs incorporate the next generation of quality and outcomes measures, will be a featured exhibitor at the National Association for Independent Review Organization’s (NAIRO) 2017 symposium – Trust in Healthcare. The conference, to be attended by national thought leaders in the medical review field, will be held Oct. 16-18, in Nashville, Tennessee. Michael D. Reisman, the president of CHQI and a former Assistant Attorney General in New York, will be a featured speaker. To register for the conference, click here.

As part of his NAIRO conference presentation, entitled An Overview of How Legal and Regulatory Trends are Impacting Health Insurance Appeals, Reisman will discuss recent court cases that have increased the potential litigation risks faced by independent review organizations (IROs), health insurers and companies providing utilization review (UR) services. These lawsuits have raised questions about the fiduciary duties and liabilities of IROs when rendering health coverage decisions. “Consumers have increasingly expressed dissatisfaction with the utilization review system, as evidenced by the depth and breadth of cases being filed,” says Reisman. “Insurers, health benefit administrators, and IROs need to have greater awareness of these trends and their regulatory obligations.”

Under Reisman’s leadership, CHQI is developing two innovative accreditation programs for health insurers, benefits administrators, and independent review organizations. CHQI’s Insurance Appeals Accreditation Program will provide a uniform set of national standards reflecting current legal requirements and best practices, making the insurance appeals system more efficient, transparent, and fair. To learn more about this…

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