New Health Plan Report Card
In April 1998, The National Committee for Quality Assurance (NCQA) began regular and full disclosure of the accreditation status of organizations surveyed or scheduled to be surveyed under the Standards for the Accreditation of New Health Plans (NHP). The NHP Accreditation Status List, updated on the 15th of each month, catalogs all NHPs that have an accreditation status with NCQA, all NHPs with pending accreditation decisions and all NHPs scheduled to be surveyed.
New Health Plan Accreditation
 Plan NamePlan Office LocationNHP Review DateScheduled HPA Review DateAccreditation Status

Anthem Insurance Companies, Inc. dba Anthem Blue Cross and Blue Shield in Indiana

Indiana10/12/2009 09/16/2012Accredited
AMERIGROUP Community Care OhioCincinnati, OH08/27/200808/30/2011Accredited
AMERIGROUP Virginia, Inc.Merrifield, VA11/12/200711/08/2010Accredited
AMGP Georgia Managed Care CompanyAtlanta, GA10/08/200709/20/2010Accredited

Delaware Physicians Care, Inc.

Newark, DE06/11/2007 Accredited
MDwise, Inc.Indianapolis, IN09/01/200908/14/2012Accredited
Molina Healthcare of Ohio, Inc.Columbus, OH11/17/200811/02/2011Accredited

Molina Healthcare of Texas, Inc.

      

San Antonio, TX04/27/200904/24/2012Accredited
Optimum HealthCare, Inc.Spring Hill, FL08/20/200708/30/2010Accredited
Peach State Health PlanSmyrna, GA09/17/200809/21/2011Accredited
Sunshine State Health PlanFlorida12/07/200912/12/2012 Accredited
Unison Health Plan of Delaware, Inc.Pittsburgh, PA04/27/201004/17/2013Accredited

Unison Health Plan of Ohio, Inc.

Pittsburgh, PA10/20/200810/03/2011Accredited
Unison Health Plan of South Carolina, Inc.Pittsburgh, PA10/15/200710/18/2010Accredited
Unison Health Plan of the Capital AreaPittsburgh, PA08/31/200908/27/2012Accredited
Wellcare of Georgia, Inc.Atlanta, GA05/05/200805/03/2011Accredited
Decisions Pending
Surveys Scheduled

What is the NHP Accreditation Status List?
The list is in three parts, each organized alphabetically. Part 1 shows all NHPs that have a current accreditation status; Part 2 shows NHPs with decisions pending; and Part 3 shows NHPs with surveys scheduled within the next 18 months. NHPs that are not on the list have not scheduled an NCQA Accreditation survey.

Part 1: Current Accreditation Status. The levels of accreditation decisions are described briefly below. For a complete description, see the revised NCQA Policies and Procedures.

NHP Accreditation is granted for a period of three years to those NHPs that have in place sound organizational structures and processes to monitor and improve the quality of care and service provided to its members and meet NCQA's rigorous standards for NHPs.

Denial is given to those NHPs that do not qualify for accreditation.

Under Review denotes those NHPs for which an initial accreditation determination has been made but is under review at the request of the NHP.

Expired denotes a NHP that has allowed its accreditation status to lapse without scheduling another accreditation survey. The NHP may undergo only one survey under the NHP standards, any subsequent surveys are under the full Standards for the Accreditation of Managed Care Organization in effect at the time of the survey. NHPs receiving a denial do not revert to "expired."

NCQA Discretionary Review denotes those NHPs which NCQA has chosen to review in order to assess the appropriateness of an existing accreditation decision.

Part 2: Initial Decision Pending lists those NHPs that have been reviewed for the first time but have not yet received a decision.

Part 3: Future Review Scheduled shows the date of all initial reviews scheduled within the next 18 months.

How Should Consumers and Purchasers Use the List?
Accreditation status is not a guarantee of the quality of care that any individual patient will receive or that any individual physician or other provider delivers. However, NHPs that are accredited have demonstrated that they provide the consumer protections required by NCQA standards and that they have in place the structure and foundation to monitor and continuously improve the quality of care they deliver.

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