No. By "in print," NCQA means a printed copy of a document that is made available (e.g., by mail) to eligible individuals who may not have access to the Internet.
Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can ask a question through My NCQA.
The Exchange Add-on Survey evaluates plans on a subset of standards and elements listed in Section 7 of the NCQA HPA Exchange Add-on Survey Application. For an organization that will administer its Exchange product line in the same manner as it administers existing NCQA-Accredited product lines, NCQA will award Accreditation to the Exchange product line without conducting a formal survey. An organization qualifies for automatic Accreditation if it attests that it will administer 70% or more of the elements listed in Section 7 in the same manner.
No. GFR testing is not currently acceptable for the Medical Attention for Nephropathy indicator. Clinical experts determined that certain characteristics, such as age, sex and race, may impact the effectiveness of such tests for monitoring nephropathy. If a member was determined to have impaired kidney function based on a GFR test, it is expected that there would be other documentation in the medical record that would make the member compliant for the nephropathy indicator (e.g., documentation of a visit to a nephrologist or documentation of medical attention for any appropriate conditions listed in the specifications).
Although the event/diagnosis criteria do not specifically state "and/or," it is implied. As long as there are two outpatient visits or two nonacute inpatient discharges, or one outpatient visit and one nonacute inpatient discharge, with a diagnosis of RA, the member meets the criteria for eligible population.
NCQA will expand the look-back period if it is necessary for plans to demonstrate that performance requirements are met and to produce an adequate sample for file reviews. For annual requirements, plans must complete the activity at least once during the prior year.
Yes, a plan may apply for a new Accreditation Survey (called an Expedited Survey) in less than a year under specific circumstances, including:
The plan was denied accreditation under the Interim Evaluation Option and may reapply after three months.
The organization demonstrates to NCQAs satisfaction that the issues identified in the original survey can be corrected within a six- to nine-month time frame as a result of the organizations activity.
Correction of the issues would raise the organizations accreditation status in a new survey.
To qualify for an Expedited Survey, a plan must submit a written request listing the steps it has taken to address the substantive issues that led to its Denied Accreditation status.