NCQA Programs Public Comment

The National Committee for Quality Assurance (NCQA) invites the public to comment on its proposed AI Standards in the 2027 Health Plan Accreditation and Health Plan Ratings programs as part of our ongoing efforts to ensure transparency, inclusion and community input in the decision-making process. We value the perspectives of health care industry professionals, patients, health plan stakeholders, state agencies, and others that play a critical role in shaping policies that directly impact public health and well-being. Your feedback will be instrumental in guiding our next steps and helping to ensure that our actions align with the needs and concerns of the communities we serve.

• Submit your comments by December 5 at 11:59pm (ET), and help us continue to improve health care for all.

Proposed Health Plan Accreditation Program Updates

Shaping the Future of Health Plan Accreditation: NCQA’s Approach to Artificial Intelligence

NCQA accredits more than 1,200 health plans, impacting over 180 million lives across the United States. As artificial intelligence (AI) rapidly transforms healthcare, NCQA recognizes its growing influence on the processes and functions evaluated through Health Plan Accreditation. To remain responsive to emerging technologies, NCQA is evolving its standards to reflect these changes while preserving patient safety and guiding innovation to enable meaningful quality improvement.

NCQA is introducing a new category of standards in Health Plan Accreditation 2027. These standards will address critical domains including AI program structure, governance, pre-deployment evaluation, and ongoing monitoring and intervention. This initiative reflects NCQA’s mission to strengthen safeguards, prioritize patient safety, and promote transparency in areas where AI increasingly supports and influences patient care and services.

We Want to Hear From You

As NCQA develops new standards to guide the responsible use of AI in Health Plan Accreditation, your voice matters. We invite stakeholders, experts, and members of the public to share feedback that will help shape these standards and ensure they reflect the realities of care delivery, innovation, and patient protection. The goal is to develop practical standards that are adaptable to organizations nationwide regardless of their current stage of maturity, and establish a foundation that facilitates safe, effective, and equitable use of AI.

Documents

• AI Standards in 2027 HPA_Overview Memo
• AI Standards in 2027 HPA_Proposed Standards Updates

PROPOSED HEALTH PLAN RATINGS UPDATES

NCQA invites the public to comment on proposed changes to the required measures list for 2026 and 2027 Health Plan Ratings.

NCQA Health Plan Ratings evaluate commercial, Medicare and Medicaid health plans based on the quality of care patients receive, patient satisfaction with their care and health plans’ efforts to continuously improve. Ratings are updated annually to ensure consumers have the most accurate information about health plan quality and performance to make informed choices about their care.

A key concern for any quality rating tool is the certainty of its judgment—we want to ensure that plans assigned a higher value truly deserve it. If the rating system includes redundant measures, or measures with poor statistical properties, it may risk rewarding random variation over true quality differences.

NCQA uses comprehensive measure selection criteria to determine which HEDIS® and CAHPS® measures are proposed for inclusion in or removal from Health Plan Ratings. These criteria ensure that all measures exhibit desirable statistical properties, are utilized in programs and value-based payment initiatives and eliminate redundancy.

We now seek the public’s feedback on the following proposed changes.

• 2026 Health Plan Ratings:
  • Remove two measures from the Medicare product line.
• 2027 Health Plan Ratings:
  • Add one measure to the Medicaid product line.
  • Remove six measures across product lines.

DOCUMENTS

• 2026/2027 Health Plan Ratings Overview Memo

About Public Comment

The public comment system is integrated with NCQA’s single-sign-on platform. If you have access to any of the systems listed here, you can use the same credentials to log in and submit comments:

• My NCQA
• Interactive Data Submission System (IDSS)
• Health Organization Questionnaire (HOQ)
• Download Center
• Recognition Program Online Application
• Quality Compass

Sign in to Comment

Note: The Forgot Password feature will change the password for all NCQA systems to which you have access. If you do not have access to any system listed above, click Create an Account and complete the entire form. Retain the password for your records.

Submitting Comments

Submit all comments through the My NCQA portal. NCQA does not accept comments by mail, email or fax.

NCQA reviews all feedback submitted during the public comment period. To submit comments:

1. Go to My NCQA and enter your email address and password.
2. Once logged in, scroll down and click Public Comments.
3. Click Add Comment to open the comment box.
4. Click to select one or more programs from the drop-down box:
   • Experience with NCQA’s Public Comment
     • New AI Standards in 2027 HPA
     • 2026 and 2027 Health Plan Ratings
5. Click to select the Topic and Element (question) on which you would like to comment.
6. Click to select your support option (Support, Do not support, Support with modifications).
   • If you choose Do not support, include your rationale in the text box.
   • If you choose Support with modifications, enter the suggested modification in the text box.
7. Enter your comments in the Comments box.
   Note: There is a 2,500-character limit for each comment. We suggest you develop your comments in Word to check your character limit; use the “cut and paste” function to copy your comment into the Comments box.
8. Use the Submit button to submit more than one comment. Use the Close button to finish leaving comments. You can view all submitted comments in the Public Comments module.

Reviewers are asked to submit comments by 11:59 p.m. (ET) on Friday, December 5.

Sign in to Comment