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  1. Standards - UMCR - Other

    Last modified 01.19.2021
    ncqa.org/programs/health-plans/utilization-management/benefits-support/standards/

    Utilization Management Accreditation Requirements NCQA Utilization Management Accreditation evaluates organizations performing full-scope utilization management services. Organizations must meet program criteria to pursue this accreditation.

  2. Benefits & Support - WHP - Other

    Last modified 01.19.2021
    ncqa.org/programs/health-plans/wellness-and-health-promotion-whp/benefits-support/

    Wellness and Health Promotion Benefits & Support NCQA Wellness and Health Promotion Accreditation/Certification benefits impact operational performance and marketplace competitiveness.Organizations seeking certification receive resources and…

  3. Process - LTSS Distinction

    Last modified 01.19.2021
    ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/process/

    Long-Term Services and Supports Distinction for Health Plans Process This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation.…

  4. Standards - LTSS Distinction

    Last modified 01.19.2021
    ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/standards/

    Long-Term Services and Supports Distinction for Health Plans Requirements NCQA Long-Term Services and Supports (LTSS) Distinction for Health Plans evaluates organizations that provide medical and…

  5. Disease Management

    Last modified 01.14.2021
    ncqa.org/programs/health-plans/disease-management-dm/

    Disease Management Accreditation/Certification

  6. NCQA HEDIS Measurement Year (MY) 2020 Requirements and COVID-19

    Last modified 12.08.2020
    ncqa.org/hedis/measures/ncqa-hedis-measurement-year-my-2020-requirements-and-covid-19/

    Updated: November 24, 2020 NCQA continues to monitor the impact of the coronavirus pandemic on health plan business operations, including its potential effect on medical…

  7. IRT Release Schedule

    Last modified 11.20.2020
    ncqa.org/programs/health-plans/health-plan-accreditation-hpa/current-customers/hpa2020/standards-release-dates/irt-november-2020/

    Access to the IRT system may be intermittent from 8pm Friday, November 20–8am Monday, November 23, while updates are tested. What’s Changing? For organizations, we…

  8. Current Customers

    Last modified 08.11.2020
    ncqa.org/programs/health-plans/population-health-program-accreditation/current-customers/

    Current Population Health Program Customers Many organizations seek NCQA Population Health Program Accreditation for the benefits it offers.

  9. IRT Release Schedule

    Last modified 07.23.2020
    ncqa.org/programs/health-plans/health-plan-accreditation-hpa/current-customers/hpa2020/standards-release-dates/irt-july-2020/

    Access to the IRT system may be intermittent from 8pm Friday, July 24–8am Monday, July 27, while updates are tested. What’s Changing? For organizations, we…

  10. Vendors

    Last modified 07.21.2020
    ncqa.org/programs/data-and-information-technology/hit-and-data-certification/population-health-management-prevalidation/vendors/

    We recommend contacting the health IT vendor to review their capabilities and identify where automatic credit may apply.

  11. IRT Release Schedule

    Last modified 07.10.2020
    ncqa.org/programs/health-plans/health-plan-accreditation-hpa/current-customers/hpa2020/standards-release-dates/irt-march-2020/

    The IRT system will not be available from 5pm Friday, March 27–8am Monday, March 30, while updates are tested. What’s Changing? Based on your input,…

  12. Virtual Onsite Renewal Survey

    Last modified 04.21.2020
    ncqa.org/programs/health-plans/virtual-onsite-renewal-survey/

    As part of the “regular” accreditation/certification survey, NCQA spends one or two days onsite at an organization conducting file review. In a “virtual” onsite, NCQA…