No. For NCQA Health Plan Accreditation, NCQA reviews and scores UM 1, Elements B–H separately for each product line brought forward for Accreditation. Organizations may not combine any product lines—including commercial and Exchange—when reporting and evaluating UM rates for UM 1, Elements B–H.
Applicable standards:
- Health Plan Accreditation: UM 1, Elements B-H.
- Behavioral Health Accreditation: UM 1, Elements B-F.
- Utilization Management Accreditation: UM 3, Elements B-H.