June 23, 2025
Statement attributed to:
Eric Musser, MPH
Vice President of Federal Affairs
“NCQA commends the leadership at the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) for advancing meaningful prior authorization reform, supported by strong industry consensus. Streamlining prior authorization processes is essential to reducing care delays and easing administrative burdens for both patients and clinicians.
At NCQA, we share this commitment and have proactively taken steps to support these types of reforms. We’ve strengthened our Utilization Management standards across NCQA programs – including Health Plan Accreditation – to better align with the 2024 CMS Interoperability and Prior Authorization Final Rule. These updates are designed to promote timely access to care, increase transparency, and reinforce clinically sound, patient-centered decision-making.
Our enhanced standards reflect NCQA’s dedication to supporting CMS in its efforts to create a more transparent health care system and to hold insurance companies accountable for delivering measurable improvements that will lead to real, sustained changes for patients and clinicians alike.”
About NCQA
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA Accredits and Certifies a wide range of health care organizations. It also Recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make informed health care choices. NCQA can also be found at Twitter @ncqa and on LinkedIn at linkedin.com/company/ncqa.
Media Contact
Theresa Masnik
SHIFT Communications
NCQA@shiftcomm.com