The application will be available by the end of September 2012 and can be submitted anytime; however, NCQA will not begin Exchange Add-on surveys until after January 1, 2013. Note that applications will only be accepted through December 31, 2013, as the Exchange Add-on Survey is a temporary strategy to help plans receive accreditation to qualify for Exchanges.
FAQ Directory
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.
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9.15.2012 Timing When is the first date that I can submit my application for the Exchanges Add-on Survey?
9.15.2012 Pricing What is due at the time of the application submission?
9.15.2012 Pricing What is due at the time of the actual survey date?
Base fee is $15,000 if an organization qualifies for automatic accreditation and $22,500 if an organization must go through a review. However, this includes the already submitted application submission fee. Actual additional amount required prior to NCQA awarding automatic accreditation is $5,000 or prior to the survey date if a review is required is $12,500. NCQA will bill organizations for the remainder of the fees due prior to awarding automatic accreditation or conducting the survey.
8.16.2012 Comprehensive Diabetes Care May documentation of the glomerular filtration rate (GFR) test be used when reporting the Medical Attention for Nephropathy indicator?
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).
HEDIS 2013
8.16.2012 Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis What combination of visits with a diagnosis of rheumatoid arthritis may be used to meet the event/diagnosis criteria?
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.
HEDIS 2013