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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NCQA LTSS Distinction for Health Plans is a complementary program designed to support health plans coordinating LTSS. The program standards provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state requirements.
The Standards and Guidelines document can be found in the NCQA eStore.
The Accreditation/Certification assesses an organization’s performance in the following requirement areas:
NCQA Managed Behavioral Healthcare Organization Accreditation is a comprehensive, evidence-based evaluation that reviews organizations to assure they use processes to deliver high-quality care and access. It provides a framework for organizations to align and improve operations in areas of quality improvement, care coordination, utilization management and credentialing and recredentialing and members’ rights.
Organizations that have earned NCQA LTSS Distinction can be found in the NCQA Report Card.
The typical evaluation timeframe, from application submission to decision, is 12 months. This depends on the organization’s readiness, as some organizations may already be working within NCQA guidelines.
Several organizations have earned NCQA Provider Network Accreditation. See the NCQA Report Card for a directory of accredited organizations.
| NCQA Wellness and Health Promotion Accreditation/Certification focuses on services most desired by employers and health plans as well as expected by consumers. It provides a framework for organizations to implement industry best practices and apply evidence-based methods proven to support health and improve outcomes.
The standards help health and wellness organizations identify gaps for improvement and align their services with those desired by potential contracting organizations. |
Use the NCQA Provider Network Accreditation standards to perform a gap analysis and determine improvement areas. The standards provide a framework for implementing industry best practices to:
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Earning NCQA Accreditation of Case Management for LTSS can help organizations:
Provider Network Accreditation assesses an organization’s performance in the following key areas:
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