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  1. 2024 Case Management for Long-Term Services and Supports Survey Tool (web-based)

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    2024 CASE MANAGEMENT FOR LONG-TERM SERVICES AND SUPPORTS SURVEY TOOL
    Note: This Survey Tool is accessed through NCQA's Interactive Review Tool (IRT) system.
    The Survey Tool includes all information ...

  2. 2023 HP Medicare Advantage Deeming Module (epub)

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    2023 HP MEDICARE ADVANTAGE DEEMING MODULE
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2023 ONWARD.
      View Table of Contents for this Publication
    NCQA’s Medicare Advantage (MA) Deeming...

  3. 2022 Medicaid Managed Care Toolkit

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    2022 MEDICAID MANAGED CARE TOOLKIT
    NCQA's Medicaid Managed Care Toolkit provides states and their contracted quality partners with a guide to making the most of accreditation and the HEDIS and CAHPS ...

  4. HEDIS MY 2022 Volume 5 (epub)

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    HEDIS MEASUREMENT YEAR 2022 VOLUME 5: HEDIS COMPLIANCE AUDIT: STANDARDS, POLICIES AND PROCEDURES
      View Table of Contents for this Publication
    Note: NCQA has updated the naming convention ...

  5. 2022 Health Plan Ratings in Excel Format (For Internal Use Only by Customer)

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    2022 HEALTH PLAN RATINGS IN EXCEL FORMAT (FOR INTERNAL USE ONLY BY CUSTOMER)
    NCQA's Health Plan Ratings includes commercial, Medicare and Medicaid health plans. The overall rating is the weighted ave...

  6. 2021 Medicaid Managed Care Toolkit

    Product 11.30.-0001
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    2021 MEDICAID MANAGED CARE TOOLKIT
    NCQA's Medicaid Managed Care Toolkit provides states and their contracted quality partners with a guide to making the most of accreditation and the HEDIS and CAHPS ...

  7. 2022 Specialty Pharmacy Survey Tool (web-based)

    Product 11.30.-0001
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    2022 SPECIALTY PHARMACY ACCREDITATION SURVEY TOOL
    Note: This Survey Tool is accessed through NCQA's Interactive Review Tool (IRT) system.
    The Survey Tool includes all information needed to prepare and...

  8. 2022 Specialty Pharmacy Standards and Guidelines (web-based)

    Product 11.30.-0001
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    2022 STANDARDS AND GUIDELINES FOR THE ACCREDITATION OF SPECIALTY PHARMACIES
    Note: This publication is made accessible in NCQA's Interactive Review Tool (IRT) system. It cannot be downloaded. For a dow...

  9. HEDIS MY 2021 Volume 5 (epub)

    Product 11.30.-0001
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    HEDIS MEASUREMENT YEAR 2021 VOLUME 5: HEDIS COMPLIANCE AUDITâ„¢: STANDARDS, POLICIES AND PROCEDURES
      View Table of Contents for this Publication
    Note: NCQA has updated the naming conventi...

  10. 2022 UM/CR/Provider Network Standards and Guidelines (epub)

    Product 11.30.-0001
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    2022 STANDARDS AND GUIDELINES FOR ACCREDITATION IN UTILIZATION MANAGEMENT AND CREDENTIALING AND PROVIDER NETWORK
    View Table of Contents for this Publication
    This publication outlines standards and...

  11. 2022 Specialty Pharmacy Standards and Guidelines (epub)

    Product 11.30.-0001
    store.ncqa.org/index.php/catalog/product/view/id/4285

    2022 STANDARDS AND GUIDELINES FOR THE ACCREDITATION OF SPECIALTY PHARMACIES
    View Table of Contents for this Publication
    This publication features in-depth explanations and examples of how to meet th...

  12. 2021 Health Plan Ratings in Excel Format (For Internal Use Only by Customer)

    Product 11.30.-0001
    store.ncqa.org/index.php/catalog/product/view/id/4281

    2021 HEALTH PLAN RATINGS IN EXCEL FORMAT (FOR INTERNAL USE ONLY BY CUSTOMER)
    NCQA’s Health Plan Ratings 2021 includes commercial, Medicare and Medicaid health plans. The overall rating is the weigh...