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Standards - Medicaid
ncqa.org/programs/health-plans/health-plan-accreditation-hpa/medicaid-module/standards/Health Plan Medicaid Module Requirements NCQA Health Plan Medicaid Module evaluates an organization’s Medicaid product line under the applicable NCQA Health Plan Accreditation program standards…
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Video Tutorials: IRT Training
ncqa.org/programs/health-plans/interactive-review-tool-irt/video-tutorials-irt-training/Video Tutorials: IRT Training These videos help you walk through tasks in the Interactive Review Tool (IRT). IRT is the survey tool used to complete…
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Get Started - LTSS Distinction for Case Management Organizations
ncqa.org/programs/health-plans/ltss-distinction-for-case-management/get-started/As the population ages, more states are seeking to increase accountability, improve quality and promote a cost-effective service delivery system. States and managed care organizations…
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LTSS Distinction for Case Management
ncqa.org/programs/health-plans/ltss-distinction-for-case-management/Long-term Services and Supports Distinction for Case Management Organizations As the population ages, more states are seeking to increase accountability, improve quality and promote a…
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NCQA Announces Inaugural Participants in AI Governance Working Group
ncqa.org/news/ncqa-announces-inaugural-participants-in-ai-governance-working-group/Participants in AI Working Group announced
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NCQA Unveils 2025 Health Plan Ratings
ncqa.org/news/ncqa-unveils-2025-health-plan-ratings/11 health plans earn top 5-star rating.
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Enabling Better Health Through Interoperability: NCQA Statement on the CMS Interoperability Framework and Digital Health EcosystemÂ
ncqa.org/news/enabling-better-health-through-interoperability-ncqa-statement-on-the-cms-interoperability-framework-and-digital-health-ecosystem/How CMS’s vision affirms the industry shift toward standards-based data exchange and the future of digital quality.
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NCQA Commends HHS and CMS for Advancing Prior Authorization Reform
ncqa.org/news/ncqa-commends-hhs-and-cms-for-advancing-prior-authorization-reform/Commitments mark a critical step toward reducing care delays and strengthening patient-centered health care.
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NCQA Issues Health Care Recommendations for the Trump Administration
ncqa.org/news/ncqa-issues-health-care-recommendations-for-the-trump-administration/Proposal outlines vision for evolving the quality measurement ecosystem to support patient-centered, cost-effective, integrated care
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NCQA Unveils 2024 Health Plan Ratings
ncqa.org/news/ncqa-unveils-2024-health-plan-ratings/This year 5 health plans achieved a 5-star rating.
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NCQA Updates 2025 Credentialing Product Suite
ncqa.org/news/ncqa-updates-2025-credentialing-product-suite/Updates ensure consistent, effective and diligent qualification verification process
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NCQA applauds the Office of Management and Budget’s updates to SPD 15
ncqa.org/news/ncqa-applauds-the-office-of-management-and-budgets-updates-to-spd-15/The revisions to SPD 15 will facilitate better, more complete equity data collection.