No. NCQA conducts onsite surveys for the First and Renewal Evaluation Options, but not for the Interim Evaluation Option.
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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8.15.2012 Evaluation Options: Survey Process Will NCQA conduct onsite surveys (at the health plan) for the Interim Evaluation Option?
8.15.2012 Evaluation Options: Standards and Guidelines CR 7: Recredentialing Verification was eliminated for Accreditation 2013. Is there a recredentialing requirement?
8.15.2012 Evaluation Options: Status and Scoring How are plans scored that do not report HEDIS/CAHPS?
8.15.2012 Evaluation Options: Status and Scoring Does NCQA publish denials for plans undergoing the Interim Evaluation Option or the First Evaluation Option?
8.15.2012 Evaluation Options: Eligibility How long must a plan be in operation before applying for NCQA Accreditation?
Plans may apply for the Interim Evaluation Option and the First Evaluation Option at any time, regardless of how long they have been in operation.
For the Interim Evaluation Option, plans must show evidence that they met the requirements before the survey start date.
For the First Evaluation Option, plans must show that they met the requirements for the six months before their survey date.
This applies to the following Programs and Years:
8.15.2012 Evaluation Options: Standards and Guidelines Where can plans get information about standards points, HEDIS/CAHPS points for accreditation and reporting categories points?
Plans can look in Appendix 1: Standards Points for 2013, in the 2013 Standards and Guidelines, for a summary table of approximate points for each Evaluation Option. Appendix 2: HEDIS and CAHPS Points contains a summary table for approximate points for HEDIS/CAHPS measures. Appendix 3: Points by Reporting Category contains a summary table of points by reporting category.
This applies to the following Programs and Years:
8.15.2012 Evaluation Options: HEDIS Reporting and Scoring How does NCQA differentiate among plans that are accredited through the Renewal Evaluation Option and plans that are accredited through the First Evaluation Option but do not report HEDIS/CAHPS measures?
8.15.2012 Evaluation Options: HEDIS Reporting and Scoring Will NCQA review and score HEDIS/CAHPS measures if a plan submits them for the Interim Evaluation Option?
8.15.2012 Evaluation Options: Standards and Guidelines Several elements in the First Evaluation Option require annual evaluation, even though the Evaluation Option has a six-month look-back period for all other elements. How do plans meet this annual requirement?
NCQA will expand the look-back period if it is necessary for plans to demonstrate that performance requirements are met and to produce an adequate sample for file reviews. For annual requirements, plans must complete the activity at least once during the prior year.
This applies to the following Programs and Years:
7.16.2012 Medical Record Review Validation In HEDIS 2013, are there new requirements for MRRV?
For HEDIS 2013, NCQA will adopt a new audit process that uses like-measure groupings for measure validation, includes hybrid measure exclusions, applies a different statistical test to the process and clearly defines MRR milestones to ensure consistency across plans.
This applies to the following Programs and Years:
HEDIS 20137.16.2012 Medical Record Review Validation Has NCQA communicated the changes to the MRRV process?
7.16.2012 Medical Record Review Validation Why was a new statistical test chosen for MRRV?
The new test will reduce the number of errors allowed in the systematic sample collected using the Hybrid Method. Auditors will use the Squeglia Zero-based Sampling Plan, which includes more measures but has a smaller sample of 16 charts.
