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 COMMITTEES  |  MEMBERS  |  URAC ACCREDITATION

As the leader in independent medical review, NAIRO and its member organizations, which comprise URAC-accredited groups, provide objective, unbiased medical determinations, using board-certified medical reviewers, to help clinical and claims management professionals appropriately allocate health care resources.

NAIRO performs its work collaboratively in committees and working groups. It holds quarterly member conference calls, and an annual Conference to help inform current and prospective IRO members as well as healthcare organizations, media, analysts, and legislative and regulatory dignitaries.

Click here to review NAIRO's Code of Ethics Policy

COMMITTEES AND WORKING GROUPS

NAIRO has several committees that meet monthly, and from time to time initiates working groups to handle specific projects. NAIRO leadership comprises the Executive Committee, with the elected President as the Chair. The Executive Committee oversees nominations and approval for the various committee Chairs.

Accreditation Task Force

Chair: Frances Scott

To gather intelligence relative to URAC standards and share this valuable information with our members to facilitate their successful accreditation and ongoing re-accreditation.

Legislative/Regulatory Committee

Chair: Debora Santiago, DBA, CPC, CPMA, CRC, CPCO, CPC-1

Monitors and reports on developments in pending and passed legislation, regulations, and case law, through Lexis-Nexis and State Net, which affects the provision of independent medical review and utilization review.

Analyzes and recommends strategies to further NAIRO’s mission and goals with legislators, regulators, and trade associations.

Membership and Marketing Committee

Chair: Stacie Wydra, HQSI

To promote the mission and goals of NAIRO using a variety of communication media including the web site, press releases, feature articles, and position papers, providing all stakeholders with relevant information. 

To increase membership by recruiting organizations who share NAIRO’s beliefs in preserving the integrity and validity of the Independent Medical and Utilization Review process and reflect the highest standards of NAIRO’s mission and philosophy.

Conference Committee

Chair: Karen Cinibulk

Collaboration of NAIRO members on the committee to organize and execute a NAIRO Conference annually. This includes identifying a suitable location and venue, determining relevant topics, securing speakers that are subject matter experts in their respective disciplines, and raising monies through sponsorship to offset cost and ensure a topflight event.

URAC Standards Committee Representative

Chair: Sarah O’Hara, National Medical Reviews

Quarterly and ad hoc meetings with URAC as part of the Health Standards Committee (HSC). 

Serves as an independent advisor to URAC.

Assisting in the development of quality standards and measures for future use in URAC healthcare accreditation and certification programs or to make accreditation and/or certification decisions.

Artificial Intelligence / Cybersecurity / Technology (ACT) Committee

Chair: Allison Xiong, Ph.D.

The NAIRO ACT Committee’s mission is to advance the responsible, secure, and effective adoption of artificial intelligence and emerging technologies across the independent review industry.

Certified IDRE Collaboration (CIC) Committee

Co-Chairs: Trish Prather and Joan Ragsdale, EdiPhy Advisors

The NAIRO Certified IDRE Collaboration Committee is dedicated to supporting and advancing the integrity, quality, and operational excellence of independent, impartial review performed by NAIRO member organizations certified as Independent Dispute Resolution Entities under the No Surprises Act and facilitating collaborative, meaningful, information exchanges with the public and all stakeholders about the independent dispute resolution process.

ABOUT NAIRO CIC: The committee serves as NAIRO’s authoritative voice on federal IDR policy and practice — monitoring regulatory developments, engaging with policy makers and regulators, and providing guidance and information on IDRE certification, compliance, and dispute adjudication standards.

Grounded in NAIRO’s longstanding commitment to impartial, evidence-based review, the committee works to ensure that the federal IDR process is administered with consistency, transparency, and fairness to all parties to the process while preserving the patient protections at the heart of the No Surprises Act.

The committee further endeavors to shape a sustainable and equitable IDR ecosystem by advocating for clear and workable federal rules, sharing best practices among member IDREs, and promoting the operational standards that distinguish URAC-accredited organizations as trusted arbiters in the resolution of out-of-network payment disputes.

Bylaws Committee

Chair: Frances Scott

To maintain, interpret and recommend updates to NAIRO’s governing rules (bylaws).

The bylaws help to ensure compliant, consistent and effective operations of the organization while defining and supporting member rights, officer responsibilities, and meeting procedures.

Policies and Procedures Committee

Chair: Frances Scott

To ensure that NAIRO has a consistent and effective process for developing, maintaining, implementing and monitoring the policies and procedures that govern the organization’s core business processes.

Strategic Planning Committee

Chair: Frances Scott

Help to define NAIRO's direction, priorities, and actions to achieve long-term success. It helps the NAIRO Executive Committee and Committee Chairs set goals, allocate resources efficiently, and measure progress to ensure alignment with the NAIRO mission and vision.

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