Over the last couple of years I've heard folks say "Well since we are accredited we are fully compliant..." This should raise the hairs or the back of a compliance officer. Just because your organization maybe accredited with NCQA or URAC that doesn't mean you may be fully compliant will all state and federal regulations. Generally most folks in your organization don't get the complexities of the current regulatory climate. Because many organizations run in a silo mode most don't understand that laws and regulations have changed. While accreditation may have some weight when it comes to regulations(NCQA and Medicare for instance) they always state that Federal and state laws supersede them.
When going for an accreditation you really need to do two things. Make sure that being compliant with an accreditation does not put you at risk with the state of federal regulations. Also you need to educate your peers that getting an accreditation does not insulate from state and federal regulations. Most folks in the compliance role tend not to do much with the accreditation role. There always seems to be this clinical/ non-clinical divide for some reason. Frankly the accreditation role does not need to be a clinical person you just need to make sure that the required clinical works gets completed.
I will give Kudos to NCQA and URAC because when they update their requirements they do take into consideration what regulators are looking for. They do tend to deviate slightly on what they are looking for. Just don't assume they are 100% spot on.
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