Managed Medical Review Organization, Inc. (MMRO) has earned the Artificial Intelligence in Health Care Accreditation from URAC, the first program in the nation to set standards for responsible AI use and development in healthcare. The accreditation validates a year-long effort by MMRO to build a governance framework that prioritizes data security, clinical integrity, and human oversight before any AI tool is adopted.
Building governance from the ground up
The accreditation process required MMRO to develop responsible use policies, risk and impact assessments, and testing and training requirements aligned with URAC's framework. The program includes formal clinical oversight led by Jen Mongeau, DHA, MBA, MSN, RN, MMRO's Vice President of Clinical Programs.
"This accreditation was the result of a full year of preparation and effort, and our team should be incredibly proud," said Douglas Minke, J.D., M.B.A., Vice President of Corporate Development and General Counsel, and MMRO's Chief Information Security Officer. "We now have a governance program that lets us look at new AI technology through a clear lens: does it protect the information we review and the people we serve, and does it uphold the standard of clinical excellence our clients count on? If the answer is not yes to both, it does not move forward."
Clear limits on AI's role
MMRO said AI solutions will not be used to provide clinical judgments, determine medical necessity, issue clinical determinations or recommendations, or replace regulatory or legal review. The technology also will not act as an autonomous decisionmaker for adverse actions affecting patients, providers, or employees.
For healthcare organizations evaluating where AI for Healthcare fits into clinical workflows, these boundaries matter. MMRO's approach keeps AI in a supporting role - aiding efficiency and accuracy - while leaving clinical decisions firmly with licensed professionals.
"Growth Through Quality is more than a motto here, it is how we make decisions," said Joe Schimizzi, President and CEO of MMRO. "Obtaining the Artificial Intelligence in Health Care Accreditation from URAC ensures that as we grow and incorporate AI technology into our operations, clinical quality is the one thing we will never compromise."
A foundation of independent review expertise
MMRO, headquartered in Novi, Michigan, provides independent medical review services through one of the largest networks of licensed physicians and clinical professionals in the industry. The new AI accreditation complements MMRO's existing URAC accreditation as an Independent Review Organization, which it has held for more than 15 years.
The URAC Artificial Intelligence in Health Care Accreditation, version 1.0, is the first program of its kind in the United States. It establishes standards that address the unique challenges AI presents to healthcare data security and clinical decision-making.
Why this matters for healthcare professionals
Accreditation programs like URAC's give healthcare organizations a concrete benchmark for evaluating AI vendors and internal tools. For clinical leaders, IT security teams, and executives building AI for Executives & Strategy, MMRO's framework offers a practical model: require any AI under consideration to pass two tests - protecting patient information and maintaining clinical standards - before it moves forward. That clarity can cut through vendor hype and keep implementation decisions grounded in patient safety and regulatory compliance.
Your membership also unlocks:
