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SUMMARY:NCQA Health Plan Accreditation: 2025 Updates
DESCRIPTION:About this Live Series\nNCQA Health Plan Accreditation: 2025 
 Updates\nNCQA Health Plan Accreditation is the only program 
 in the industry that bases results on clinical performance 
 and consumer experience (HEDIS® and CAHPS®). These courses 
 will focus on taking a deep dive into all of the relevant 
 updates for the newly released 2025 standards. Our 
 experienced presenters will provide learners insight to 
 interpret the requirements\, navigate the standards\, and 
 avoid misconceptions. In addition to answering live 
 questions\, presenters address generalized scenarios and 
 provide examples based on performance improvement 
 opportunities from prior NCQA surveys.\n\nPlease note: These 
 courses present information based on Health Plan 
 Accreditation 2025 standard requirements that are released 
 in July 2024. The scope of these courses apply directly to 
 NCQA Accreditation Surveys conducted between July 1\, 2025 
 and June 30\, 2026. \n\n \n\nCourse 
 Resources\n\nPresentation slides.\nRecording of live 
 session.\nScenarios for applied learning.\nNCQA surveyor's 
 perspective of the standards.\nIPCE Credits for physicians\, 
 nurses and pharmacists.\n\nWhat You Will Learn\n\nUnderstand 
 the 2025 updates and changes to the standards and 
 requirements. \nInterpret the intent of HPA 
 requirements.\nDescribe relationships and themes across the 
 standards.\nRecognize requirement implications and 
 considerations for stakeholders.\nDefine performance 
 improvement opportunities.\n\nHEDIS® is a registered 
 trademark of the National Committee for Quality Assurance 
 (NCQA).\nCAHPS® is a registered trademark of the Agency for 
 Healthcare Research and Quality (AHRQ).\n\nWho Should 
 Attend\nClinicians\, executives\, managers\, specialists\, 
 delegates\, and vendors who are employed or contracted by 
 health plans with responsibilities pertaining to the scope 
 of work listed below:\n\n\nHealth care professional.\nHealth 
 decision maker.\nConsultant.\nHealth plan.\nHealth 
 Systems\nPopulation health organization\n\nLive 
 Dates\nNetwork Management - October 1\, 2024\nIndividual 
 Cost: $349\n\n\nMember Experience - October 3\, 
 2024\nIndividual Cost: $349\n\n\nQuality Improvement - 
 October 9\, 2024\nIndividual Cost: $349\n \nDelegation - 
 October 17\, 2024\nIndividual Cost: $395\n\nUtilization 
 Management - October 22\, 2024\nIndividual Cost: 
 $395\n\nPopulation Health - October 24\, 2024\nIndividual 
 Cost: $349\n\n\n\nCredentialing - November 13\, 
 2024\nIndividual Cost: $395\n\n \n\nFaculty\nKimberly 
 Carpenter Petit\, MBA\, BS\n\nKimberly Carpenter Petit’s 
 career began in sales\, consulting\, and operations at a 
 medical device company then transitioned to a national 
 health plan with broad responsibilities for quality 
 management\, credentialing\, delegation\, accreditation\, HEDIS\, 
 and regulatory compliance.  During this time\, she gained 
 expertise in NCQA accreditation and became an NCQA Surveyor 
 in 2009. Kimberly joined Managed Healthcare Resources in 
 2017 as a Healthcare Consultant.  \n\nKim’s early career 
 was at NeuroMed Services Inc. in various sales\, consulting\, 
 and operation roles.  After three years\, she learned her 
 love for quality and began consulting with same-day surgery 
 centers on AAAHC accreditation. \n\nIn 2001 Kim moved to 
 Aetna where she held progressive roles through 2016. 
 Starting in quality management at a regional level\, her role 
 expanded several times up to nationwide responsibility for 
 accreditation\, HEDIS\, regulatory/compliance\, quality\, 
 credentialing\, and delegation. \n\nMost recently Kim was the 
 Sr. Director\, Head of QM Program\, 
 Accreditation\, Credentialing\, and Delegated Credentialing 
 for all Commercial\, Medicare\, and Exchange product lines 
 across Aetna\, Coventry and Joint Ventures.  In this role\, 
 she set strategy and executed the National Quality Program 
 to meet regulatory requirements and maintain NCQA 
 accreditation.   \n\nIn 2017 Kim began consulting on NCQA 
 preparation\, drawing from her numerous and varied 
 accreditation experiences. She successfully guided many 
 organizations through preparing and achieving NCQA 
 Accreditation and Certification.\n\nKim earned her Master of 
 Business Administration from the Kellstadt Graduate School 
 of Business at DePaul University where she is an adjunct 
 professor teaching a graduate course in Health Technology\, 
 Informatics & Quality\, a Health Insurance Industry 
 Perspective.  Kim received her Bachelor of Science from the 
 University of Illinois\, 
 Champaign-Urbana.   \n\n \n\n\nIrv Koehler\, RN\, MBA\, 
 CPHQ\, CPC\n\nIrv Koehler is a health care quality consultant 
 for the Koehler Quality Group\, LLC. In this position\, he is 
 an NCQA administrative surveyor and provides consulting 
 services to organizations evaluating and preparing for NCQA 
 Accreditation/ Certification projects\, risk adjustment 
 validation for managed care organizations\, education on 
 quality improvement practices and outcome measure 
 development and tracking.  \n\nMr. Koehler is also a 
 registered nurse with active licensure in Florida and 
 Tennessee\, and certification in quality and medical coding. 
 Previously\, he was a quality improvement professional at 
 AmeriHealth Caritas and BlueCross BlueShield of 
 Tennessee.\n\nMr. Koehler has an MBA from the Florida 
 Institute of Technology\, a BS in Nursing from Florida 
 Southern College\, a BA in Psychology and an ADN from Purdue 
 University.\n\n\n\n\nClint Koenig\, MD\, MSPH\, MA\n\nClint 
 Koenig\, MD\, MA\, MSPH is the Senior Medical Director at 
 OhioHealthy\, a new system-based health plan in Columbus\, 
 Ohio. He has served as State Medical Director in New 
 Hampshire and Ohio. Other leadership roles include the 
 Health Plan Regional Chief Medical Officer at Universal 
 American\, a government programs health management 
 organization in Syracuse\, New York\, as well as\, the Director 
 for Utilization Management at Monroe Plan for Medical Care\, 
 a healthcare management organization in Rochester\, New York. 
 In addition\, Clint held Chief Medical Officer roles in 
 Federally Qualified Health Centers and integrated delivery 
 systems.\n\nHe has been an NCQA surveyor for 10 years and 
 surveys health plans\, Patient Centered Medical Home\, Special 
 Needs Plans and Long Term Services and Supports 
 organizations.\n\nDr. Koenig received his MD from Albany 
 Medical College in Albany\, New York. He completed his 
 residency in Family Medicine\, from the University of 
 Missouri. He also completed a fellowship at the University 
 of Missouri\, where he received a master’s degree in 
 Public Health and Journalism.\n\n \n\nContinuing 
 Education\nThe Credits listed below will be provided at the 
 individual Course Level.\nIn support of improving patient 
 care\, the National Committee for Quality Assurance is 
 jointly accredited by the Accreditation Council for 
 Continuing Medical Education (ACCME)\, the Accreditation 
 Council for Pharmacy Education (ACPE)\, the American Nurses 
 Credentialing Center (ANCC) to provide Interprofessional 
 Continuing Education for the healthcare 
 team. \n\n \n\nHealth Plan Accreditation 2025 Updates: 
 Network Management\n\nThis activity was planned by and for 
 the healthcare team\, and learners will receive 3.0 
 Interprofessional Continuing Education (IPCE) credit for 
 learning and change.\n\nThis educational activity is 
 approved for a maximum of 3.0 AMA PRA Category 1 Credit™\, 
 3.0 Nursing contact hours and 3.0 ACPE contact hours.\n\nThe 
 assigned universal program number: 
 JA0004597-0000-24-018-L04-P. Upon successful completion of 
 this program (attending the full session and completing a 
 program evaluation)\, participants will access CPE Monitor on 
 the ACPE website to locate and track their CPE statement of 
 credit.\n\nThis live course grants 2.0 Continuing Education 
 Unit (CEU) points for PCMH Certified Content 
 Experts.  \n\n*Please note – You must attend the 
 entire program to be eligible for total number of contact 
 hours.\n\n \n\nHealth Plan Accreditation 2025 Updates: 
 Member Experience\n\nThis activity was planned by and for 
 the healthcare team\, and learners will receive 3.0 
 Interprofessional Continuing Education (IPCE) credit for 
 learning and change.\n\nThis educational activity is 
 approved for a maximum of 3.0 AMA PRA Category 1 Credit™\, 
 3.0 Nursing contact hours and 3.0 ACPE contact hours.\n\nThe 
 assigned universal program number: 
 JA0004597-0000-24-012-L04-P. Upon successful completion of 
 this program (attending the full session and completing a 
 program evaluation)\, participants will access CPE Monitor on 
 the ACPE website to locate and track their CPE statement of 
 credit.\n\nThis live course grants 2.0 Continuing Education 
 Unit (CEU) points for PCMH Certified Content 
 Experts.  \n\n*Please note – You must attend the 
 entire program to be eligible for total number of contact 
 hours.\n\n \n\nHealth Plan Accreditation 2025 Updates: 
 Credentialing\n\nThis activity was planned by and for the 
 healthcare team\, and learners will receive 3.0 
 Interprofessional Continuing Education (IPCE) credit for 
 learning and change.\n\nThis educational activity is 
 approved for a maximum of 3.0 AMA PRA Category 1 Credit™\, 
 3.0 Nursing contact hours and 3.0 ACPE contact hours.\n\nThe 
 assigned universal program number: 
 JA0004597-0000-24-019-L04-P . Upon successful completion of 
 this program (attending the full session and completing a 
 program evaluation)\, participants will access CPE Monitor on 
 the ACPE website to locate and track their CPE statement of 
 credit.\n\nThis live course grants 2.0 Continuing Education 
 Unit (CEU) points for PCMH Certified Content 
 Experts.  \n\n*Please note – You must attend the 
 entire program to be eligible for total number of contact 
 hours.\n \n\nHealth Plan Accreditation 2025 Updates: 
 Quality Improvement\n\nThis activity was planned by and for 
 the healthcare team\, and learners will receive 
 2.0 Interprofessional Continuing Education (IPCE) credit 
 for learning and change.\n\nThis educational activity is 
 approved for a maximum of 2.0 AMA PRA Category 1 Credit™\, 
 2.0 nursing contact hours and 2.0 ACPE contact hours.\n\nThe 
 assigned universal program number: 
 JA0004597-0000-24-014-L04-P. Upon successful completion of 
 this program (attending the full session and completing a 
 program evaluation)\, participants will access CPE Monitor on 
 the ACPE website to locate and track their CPE statement of 
 credit.\n\nThis live course grants 2.0 Continuing Education 
 Unit (CEU) points for PCMH Certified Content 
 Experts.  \n\n*Please note – You must attend the 
 entire program to be eligible for total number of contact 
 hours.\n\n \n\nHealth Plan Accreditation 2025 Updates: 
 Delegation\n\nThis is a non AMA PRA Category 1 CreditTM\, ANA 
 CNE\, ACPE activity.\n\nThis live course grants 2.0 
 Continuing Education Unit (CEU) points for PCMH Certified 
 Content Experts.  \n\n*Please note – You must attend 
 the entire program to be eligible for total number of 
 contact hours\n\n \n\nHealth Plan Accreditation 2025 
 Updates: Utilization Management\n\nThis activity was planned 
 by and for the healthcare team\, and learners will receive 
 3.5 Interprofessional Continuing Education (IPCE) credit for 
 learning and change.\n\nThis educational activity is 
 approved for a maximum of 3.5 AMA PRA Category 1 Credit™\, 
 3.5 Nursing contact hours and 3.5 ACPE contact hours.\n\nThe 
 assigned universal program number: 
 JA0004597-0000-24-020-L04-P. Upon successful completion of 
 this program (attending the full session and completing a 
 program evaluation)\, participants will access CPE Monitor on 
 the ACPE website to locate and track their CPE statement of 
 credit.\n\nThis live course grants 2.0 Continuing Education 
 Unit (CEU) points for PCMH Certified Content 
 Experts.  \n\n*Please note – You must attend the 
 entire program to be eligible for total number of contact 
 hours.\n\n \n\nHealth Plan Accreditation 2025 Updates: 
 Population Health\n\nThis activity was planned by and for 
 the healthcare team\, and learners will receive 
 3.0 Interprofessional Continuing Education (IPCE) credit 
 for learning and change.\n\nThis educational activity is 
 approved for a maximum of 3.0 AMA PRA Category 1 Credit™\, 
 3.0 Nursing contact hours and 3.0 ACPE contact hours.\n\nThe 
 assigned universal program number: 
  JA0004597-0000-24-015-L04-P Upon successful completion of 
 this program (attending the full session and completing a 
 program evaluation)\, participants will access CPE Monitor on 
 the ACPE website to locate and track their CPE statement of 
 credit.\n\nThis live course grants 2.0 Continuing Education 
 Unit (CEU) points for PCMH Certified Content 
 Experts.  \n\n*Please note – You must attend the 
 entire program to be eligible for total number of contact 
 hours.\n\nNABP Credit Reporting \nIf you are a pharmacist 
 completing a course offering CPE credits\, please notify NCQA 
 through ncqa.org within 14 calendar days that you have 
 completed a CPE course. You must provide the title of the 
 course\, your NABP identification number and your DOB 
 (month/date) within the notification to NCQA. We also 
 recommend you update your education.ncqa.org profile with 
 your NABP identification number.  \n\nDISCLOSURE OF 
 RELEVANT FINANCIAL RELATIONSHIPS\nThe National Committee for 
 Quality Assurance (NCQA) endorses the Standards of the 
 Accreditation Council for Continuing Medical Education which 
 specify that sponsors of continuing medical education 
 activities and presenters at and planners for these 
 activities disclose any relevant financial relationships 
 either party might have with commercial companies whose 
 products or services are discussed in educational 
 presentations.\n\nFor sponsors\, relevant financial 
 relationships include large research grants\, institutional 
 agreements for joint initiatives\, substantial gifts\, or 
 other relationships that benefit the institution.  For 
 presenters or planning committee members\, relevant financial 
 relationships include the receipt of research grants from a 
 commercial company\, consultancies\, honoraria\, travel\, or 
 other benefits\, or having a self-managed equity interest in 
 a company\; or having an immediate family member or partner 
 with such a relationship.\n\nDisclosure of a relationship is 
 not intended to suggest or condone bias in any presentation 
 but is made to provide participants with information that 
 might be of potential importance to their evaluation of a 
 presentation.\n\nRelevant financial relationships exist with 
 the following companies/organizations:\n\nFaculty:\nIrv 
 Koehler: None\nClint Koenig: None\n\n\n\nAdditional Planning 
 Committee Member:\nFelicia Khaalid: None\n\nThis program was 
 developed in part by NCQA staff.\n\nThis program received no 
 commercial support.\n
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