NCQA’s Latest Developments in Health Plan Accreditation

Event Expiring on December 1, 2019

If you choose to make this purchase please complete your modules no later than November 30, 2019

(5 Sessions Total – All Inclusive Package)
Cost: $295.00
Duration: Approx. 4 hours

About these On Demand Webinars

Learn about the latest developments in Health Plan Accreditation directly from NCQA experts. This On-Demand event provides a convenient method to access the most current information. 

1. Health Plan Accreditation 2019 Standards Update

Veronica Locke, MHSA
Senior Policy Manager, Accreditation Policy, Product Design & Support
National Committee for Quality Assurance

During this session, participants will gain knowledge of the changes to the HPA 2019 policies and procedures, standards and guidelines and appendices. The intent of the new Medicaid standards will be discussed.

2. Utilization Management: Denials and Appeals

Dayna Bell, MS, MBA
Senior Director, Enterprise Quality and Accreditation
Health Care Service Corporation (HCSC)

Catherine Gitimu, MS
Senior Manager, Accreditation Policy, Product Design & Support
National Committee for Quality Assurance

This session is designed to help participants identify sufficient documentation for an appeal, define relevant clinical information for a denial decision, determine acceptable methods for notifying practitioners of their right to discuss a denial and identify required information in denial and appeal notices. The new utilization management timeliness requirements and UM must-pass policy will be outlined.

3. Complex Case Management: 2019 Updates

Veronica Locke, MHSA
Senior Policy Manager, Accreditation Policy, Product Design & Support
National Committee for Quality Assurance

Shelly Smith, RN, MN, CPHQ, PCMH CCE
Managing Consultant
Health Value Solutions

This session will provide an overview of the 2019 changes to the complex case management (CCM) requirements including new processes, updates to file review and changes to initial assessment, in addition to answering burning questions to ensure the successful ongoing management of CCM.

4. A Deep Dive into the Population Health Management Standards

Natalie Mueller, MPH
Product Development Manager, Product Design & Support
National Committee for Quality Assurance

During this session, NCQA staff will lead participants through an examination of common areas of confusion in the PHM category of standards. Content will focus on what to include in the PHM Strategy (PHM 1: PHM Strategy) and how to conduct a comprehensive analysis (PHM 6: PHM Impact).

5. Population Health Management New Products and Developments

Natalie Mueller, MPH
Product Development Manager, Product Design & Support
National Committee for Quality Assurance

After the release of the Population Health Management category of standards in 2018 HPA, NCQA has been developing new products and initiatives for organizations supporting population health management efforts. These new products include an Accreditation of Population Health Management Organization and Population Health Management Prevalidation for health IT vendor solutions and software, both scheduled for release in November 2018.

Continuing Education

This is a non CME/CNE/CPE activity.

Event Type

1. Self Paced