FAQ Directory: Long-Term Services and Supports Distinction for Health Plans

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9.15.2025 Ongoing Monitoring—“At least monthly” Policy Update Retraction In July, NCQA issued a Policy Update replacing “at least monthly” with “at least every 30 calendar days” under the “Time frame for reviewing sanctions, exclusions, limitations and expiration information.” Does this change mean NCQA now requires organizations to conduct reviews strictly every 30 calendar days?

In response to customer feedback, we are retracting the Policy Update issued on July 28, 2025.

Organizations must review sanctions, exclusions, limitations and expiration information at least monthly (once per month), or within 30 calendar days of receiving a new alert, if subscribed to a monitoring service. For example, an organization might conduct a review on September 1, and conduct another on October 15, 2026.

This update applies to applicable products for both the 2025 and 2026 standard years. NCQA will accept processes that follow a monthly schedule or a 30-day interval. 

We appreciate your ongoing feedback and support.

Applicable Standards:
HPA: CR 5, Element A, factors 1-3.
MBHO: CR 5, Element A, factors 1-3.
CRPN: CRA 5, Element A, factor 3; CRC 12, Element C, factors 1-3.

HP 2026