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FAQs for Changes During the Recognition Period

Recognitions for PCMH and PCSP are conferred at the practice site level, and are earned jointly by all clinicians included in the original application or who come or go during the recognition status period. PCMH/PCSP policies and procedures require that NCQA be notified of changes in location, mergers, acquisition or consolidations.

Scenario
 NCQA's Usual Response
 Ownership change only.*
 No change in recognition status.
 Location change only.*
 No change in recognition status.
 Material change in clinicians assigned to a site.*
 No change in recognition status.
 Two or more recognized practice sites merge or a recognized practice merges with an unrecognized site.
 Merged site takes recognition status/level of the final location.
 A recognized practice splits into more than one location.
 Case-by-case assessment.
*NCQA reserves the right to request a written attestation that the change resulted in no material changes in operational procedures or electronic systems; additional documentation for selected PMCH 2011 elements; a new survey submission. Recognition status may be revoked for reasonable cause at NCQA’s discretion.


FAQs for practice changes during recognition

Change of Practice Name, Ownership, Tax ID Number or NPI number

Q: Our practice’s ownership has changed. The practice name and the tax ID and group-level NPI numbers have changed, but nothing else. Does our recognition change, too?

A: No. If the ownership, tax ID or NPI numbers changed, but not the practice site location, clinicians and operations, the recognition continues through the three-year term. Submit a request to PCS.  Allow 30 days for NCQA to change your information. The new information will appear on the NCQA Public Recognition site, and will be shared in future data distributions.

New Certificates for the Office Wall

Q: Our practice name has changed and we want to update our NCQA Recognition certificate. May we get a new certificate, with our new name?

A: Yes. New certificates are $10 each. Submit a request to PPCS. Allow 30 days for receipt of new certificates.

Location Changes

Q: We are a recognized practice that is moving to a new location, but nothing else is changing (i.e., same owners, staff, policies and procedures, EHR). Will our recognition change?

A: If your entire operation transfers to a new location, your recognition will probably change. Contact your assigned manager. After NCQA verifies that your practice has simply changed locations, your data can be updated for the Recognition Directory and for future data distributions.

Mergers of Practices

Q: We are a recognized practice that is merging with a practice that is not recognized. Will this change our recognition?

A: It depends on the resulting location and configuration of the merged practice. NCQA Recognition is intended to be at the site level. When practices change their configuration, a new recognition is better for maintaining the integrity of the program.

Merged practices that will be located at an existing recognized practice site may take the recognition level and term dates of the practice at that site, but may not adopt the recognition of another practice that is involved in the merger. Newly merged practices may come through for an Add-On Survey for the practice site, or may come through for a new recognition.

Recognized practices that merge and locate at a new site may not retain their recognition. The new practice must come through for a new Recognition.

Notify your manager of any changes.

Changes in Clinicians at a Recognized Practice Site

Q: May we add clinicians to or delete clinicians from NCQA records?

A: Yes. Refer to our FAQ on Practice Changes: Adding & Deleting Clinicians.

Recognition “portability” by one or more clinicians in Recognized practice

Q: A colleague and I are leaving a recognized practice to start a new practice. Will our current recognition apply to our new practice?

A: No. Recognitions are not portable. Although the original site will retain recognition when clinicians depart, departing clinicians may not claim NCQA Recognition at a new practice site.

EHR Changes

Q: Our practice is implementing a new EHR. Do we have to wait 3 months from its implementation to submit for recognition?

A: It depends. If the EHR enables a brand new process implemented by the practice, then yes, the practice would need to wait 3 months to submit. All documented processes must be in place for at least 3 months at the time of survey submission.

If the EHR implementation does not change the practice’s processes in relation to the Recognition Program Standards and Guidelines, then no. Practices may submit reports from the old or new systems as long as the reports submitted represent data from within the 12 months prior to survey submission.