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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5.15.2023 Applicable Standards for Mail Service Organizations Considered Delegates What standards are considered a delegation relationship if an organization uses a mail service organization to meet the distribution requirements?

NCQA considers the following standards to be a delegation relationship if an organization uses a mail service organization to meet the distribution requirements:

NET 4, Element A: Notification of Termination
NET 4, Element B: Continued Access to Practitioners
UM 5, Elements A, B, C: Timeliness of UM Decisions
UM 7, Elements B, C, E, F, H, I: Denial Notices
UM 9, Elements B, D: Appropriate Handling of Appeals
UM 11, Element B: Pharmaceutical Restrictions/Preferences
UM 11, Element C: Pharmaceutical Patient Safety Issues

ALL 2023