"NCQA is releasing proposed changes to Health Plan Accreditation for public comment, including:
- Developing a more comprehensive assessment of network adequacy and provider directory accuracy by updating existing requirements and adding new requirements in a new category of standards: Network Management.
- Including new requirements to strengthen NCQA’s ability to detect systematic issues related to Utilization Management.
- Simplifying scoring for file review elements in HPA and other accreditation/certification products that contain these elements.
In addition to HPA standards updates, NCQA proposes policy changes to the following programs:
- Managed Behavioral Healthcare Organization Accreditation (MBHO)
- Wellness and Health Promotion Accreditation (WHP)
- Credentials Verification Organization Certification (CVO)
- Health Information Products Certification (HIP)
- Utilization Management and Credentialing Certification (UM/CR)"
Please click HERE for more information on the proposed changes and instructions for submitting comments.