For several years, NCQA has maintained as a business goal to expand the number of states that recognize or “deem” NCQA standards in their oversight of commercial and Medicaid plans. Through deeming, a state determines that an accreditation organization’s standards are equivalent to all or some of the state’s regulatory requirements, thereby allowing a plan accredited or certified by an approved organization to receive “credit” for the deemed areas. States recognizing standards can use the information obtained from the accreditation survey to streamline health plan monitoring and oversight.

States Recognizing NCQA Accreditation

Currently, 41 states recognize NCQA MCO accreditation in whole or part in either their commercial market and/or their Medicaid managed care program.

States Recognition of HEDIS

Currently, 38 states collect or require HEDIS/CAHPS.

Resource for State Agencies

NCQA’s Public Policy Department partners with state agencies to identify opportunities to align the state’s quality strategy and operational standards with NCQA’s requirements for performance improvement and measurement.   The Public Policy Department is available as a resource to state agencies with questions about NCQA’s programs or that wish to learn more about the process of using accreditation for streamlined oversight. 

Please contact Kristine Thurston Toppe.