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6.15.2026 Ongoing Monitoring of Licensure and Sanctions NCQA released a March 2026 Policy Update requiring organizations to monitor sanctions and licensure limitations in all states where a practitioner practices, even if those states are outside the organization’s service area or are not states where the practitioner provides care to the organization’s members. Can NCQA clarify the scope and effective date of this change?

For the 2026 standards year only, NCQA is limiting the expanded monitoring requirement under CR 5, Element A, factor 3 to practitioners initially credentialed on or after July 1, 2026. Organizations are not required to apply this expanded monitoring requirement to practitioners credentialed before this date. 

For the 2027 standards year and beyond, the expanded requirement applies to all practitioners for surveys on or after July 1, 2027.

Applicable Standards:

  • HPA: CR 5, Element A, factor 3
  • BHA: CR 5, Element A, factor 3
  • CRPN: CRA 5, Element A, factor 3 and CRC 12, Element B, factor 3

This applies to the following Programs and Years:
HP 2026|BHA 2026|CRPN 2026