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11.17.2025 2025 NCQA Medi-Cal Rx Crosswalk: Updated look-back period for UM 11, Element E What is the look-back period for the 2025 standards year for HPA UM 11, Element E for California Medicaid organizations’ First and Renewal Surveys?

NCQA updated the look-back period on the Medi-Cal Rx Crosswalk for UM 11, Element E to be “prior to the survey date” for the 2025 standards year. This applies to California Medicaid organizations only. 

The look-back period should read:

For Interim Surveys: Prior to the survey date for all Elements.
For First Surveys: 6 months for Elements A-D; prior to the survey date for Element E.
For Renewal Surveys: 12 months for Elements A and C; at least once during the prior year for Elements B and D; prior to the survey date for Element E.

This applies to the following Programs and Years:
HP 2025