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

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Michael D. Reisman to Address Regulatory Trends and Case Law Impacting Health Care Reviewers

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 program, click here.

CHQI will also soon launch the nation’s first accreditation program focused on mental health parity. CHQI’s Mental Health Parity Accreditation Program will promote access to evidence-based mental health and addiction treatment by providing a detailed compliance roadmap through the complexities of mental health parity analysis. To learn more about this program, click here.

Last month, CHQI announced the launch of the Fall 2017 Educational Series, which includes a presentation entitled Mental Health Parity Accreditation: A Pathway to Compliance. The complimentary webinar will be held on November 8, from noon – 1 p.m. EDT. To register, click here.

CHQI’s research division, RegQuest, has published cutting-edge white papers on utilization management and external review, and maintains a repository of other helpful resources for industry insiders, including a 50-state clickable map providing instant access to summaries of key regulations. To view a full list of RegQuest resources, click here.

To obtain more information on CHQI programs or other resources, contact Julie Irons, manager of accreditation programs, at (410) 696-7634 or via email at info(at)

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About ClearHealth Quality Institute™ (CHQI) (
The mission of ClearHealth Quality Institute (CHQI) is to promote quality-based practices for health plans, providers and other stakeholders across the United States and its territories. CHQI’s accreditation and certification programs help assess, track and report on trends to enhance key insurance and provider outcomes. CHQI also offers regulatory compliance solutions, hosts educational programs, publishes issue briefs, and underwrites research to raise awareness of patient safety issues and promote best practices. The organization is governed by an independent board and committee system, which is open to a wide range of volunteers to ensure transparency and accountability. CHQI provides resources to serve patients, providers, payers, government agencies, and other stakeholder groups. To learn more about CHQI, please contact us at (410) 696-7634 or info(at)

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Tony Ellis