About NAIRO
The National Association of Independent Review Organizations (NAIRO) was formed by the majority of URAC-accredited independent review organizations (IRO). The need for uniform regulations from state to state and a uniform application process is what brought NAIRO together. The primary objective of NAIRO is to simplify the regulated independent review organization application process and independent medical peer review requirements among the states.
NAIRO is dedicated to protecting the integrity of the independent medical peer review processes. Utilizing the expertise of hundreds of board-certified clinicians throughout the country, NAIRO members embrace an evidence-based approach to independent medical peer review, in order to resolve coverage disputes between enrollees and their health plans.
How do I become a NAIRO member?
What NAIRO Would Like To See Happen
NAIRO'S RECOMMENDED TEN KEY ELEMENTS FOR INCLUSION IN THE PENDING PATIENT BILL OF RIGHTS LEGISLATION CONCERNING EXTERNAL MEDICAL PEER REVIEW
- Reviewer's opinions expressed in the medical peer review should be supported by best available scientific evidence and nationally recognized clinical guidelines and consensus statements.
- Standardization of independent medical peer review processes, timeframes, methods, and credentialing requirements throughout the U.S. using a private standard setting organization.
- Require those who provide independent medical peer review to hold an unrestricted license to practice medicine or other clinical discipline in one of the 50 U.S. states (no same-state licensing or domiciliary requirements for the reviewers).
- Guarantee anonymity of those who provide independent medical peer review.
- Provide statutory immunity for Independent Review Organizations (IROs) and those who provide independent medical peer review for activities conducted in good faith.
- Do not exclude single-service Independent Review Organizations.
- Conflict of interest standards should be case-specific.
- Upon request, the patient has the right to see the reviewer's original reports.
- Medical peer review outcomes that are binding on the plan. Member must go through the independent medical peer review process before litigating.
- A modest funding plan to educate the patient regarding specific patient rights as they pertain to his/her rights to request independent medical peer review.