Sort By
Comment Letter NCQA Congratulates HHS Secretary Azar on his Confirmation
ncqa.org/comment-letter/ncqa-congratulates-hhs-secretary-azar-on-his-confirmation/NCQA looks forward to working with Azar on our shared goal of high-quality, efficient, affordable health care.
Comment Letter NCQA Comments on Senate Finance Committee Opioid Inquiry
ncqa.org/comment-letter/ncqa-comments-on-senate-finance-committee-opioid-inquiry/NCQA recommends adding HEDIS opioid measures to the Medicare Advantage Star Ratings to encourage action to address the epidemic.
Comment Letter NCQA Comments on 2019 Medicare Advantage Call Letter
ncqa.org/comment-letter/1447/NCQA supports proposed opioid limits and wider use of supplemental benefits.
Comment Letter NCQA Comments on VA MISSION Act
ncqa.org/comment-letter/ncqa-comments-on-va-mission-act/NCQA urges the VA to use our programs and expertise to help meeting MISSION Act implementation challenges.
Comment Letter NCQA Proposed Medicare Advantage Rule Comments
ncqa.org/comment-letter/ncqa-proposed-medicare-advantage-rule-comments/NCQA supports proposals to expand telehealth, unify D-SNP appeals and share Parts A & B data with Part D-only drug plans.
FAQ Under the verification time limits, NCQA added a note that states the new verification time limits apply to files processed by the organization or its delegate(s) on or after July 1, 2025. Files proce
ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/all/?faq=000024608For Health Plan, MBHO and Credentialing Accreditation, “processed” refers to the credentialing decision date. For Credentialing Certification, “processed” refers to the date when credentialing verifications…
FAQ CMS intends to dissolve Medicare-Medicaid Plan (MMP) contracts in 2026. Will that change product line rules for Accreditation?
ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/all/?faq=000024609No. Plans that are responsible for both the Medicare and Medicaid components for dual-eligible members may select Medicare, Medicaid, or both, for Accreditation purposes.
FAQ How many measures must an organization include in an improvement plan for QI 3, Elements C and D?
ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/all/?faq=000024379For Health Plan Accreditation 2025, the organization is only required to take action on one measure for Health Plan Ratings for which it received a…
FAQ NCQA posted a memo with changes to the NCQA Accreditation Standards for the 2024 and 2025 Standards Years indicating that organizations are no longer required to describe their process for system cont
ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/all/?faq=000024222No. Organizations are still required to monitor for system controls. The NA for the system controls policies and procedures requirement (e.g., UM 12, Element A,…
FAQ How many files are reviewed in a UM-CR-PN Survey for Accredited Health Plans?
ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/all/?faq=000020681For UM Accreditation, 75 files are reviewed per product line. For CR Accreditation, 75 initial credentialing files and 75 recredentialing files are reviewed. Note: For…
FAQ How many files are reviewed in a UM-CR-PN Survey for Accredited MBHOs?
ncqa.org/programs/health-plans/managed-behavioral-healthcare-organizations-mbho/faqs/all/?faq=000020683For UM Accreditation, 75 files are reviewed per product line. For CR Accreditation, 75 initial credentialing files and 75 recredentialing files are reviewed. Note: For…
FAQ Have the allowed methods to audit delegate files in CVO 15, Element C, factor 5 changed?
ncqa.org/programs/health-plans/credentials-verification-organization-cvo/faqs/all/?faq=000019909No. Delegate files may be audited using one of the following methods as described in the factor explanation and noted below: 5 percent or 50…