In 2006, NCQA created its first Medicaid Managed Care Toolkit in consultation with the Centers for Medicaid and State Operations in response to numerous inquiries from state Medicaid programs.  Since that time, we’ve received an overwhelmingly positive response and have distributed numerous copies of the toolkit to states, health plans and other stakeholders.

The toolkit explains how states can take advantage of the federal authority to streamline oversight of Medicaid managed care plans through the use of private accreditation for health plans. Using accreditation for oversight reduces unnecessary duplication in the oversight process.  The toolkit highlights the areas where NCQA’s evaluation standards and performance measures can be used to supplement and, when considered applicable, serve in lieu of relevant Medicaid requirements and complement the mandatory EQRO activities.

Crosswalk

Updated to provide additional clarification on the 2010 Health Plan Accreditation Standards,  the crosswalk is a detailed comparison of the Federal Medicaid managed care regulations to NCQA standards.  Demonstrating that a majority of NCQA’s Health Plan Accreditation standards are equivalent to the federal regulations, the crosswalk serves as starting point for states to compare their own Medicaid managed care requirements to NCQA standards.  Our staff is ready to work with states in identifying equivalent standards. Please contact Kristine Thurston Toppe for more information.