NCQA Promotional Item Pre-Approval No Longer Required

NCQA has issued the following announcement regarding pre-approval of promotional material, which is of interest to MSPs who work in the commercial CVO setting:

As of August 1, 2011, NCQA will no longer routinely require that you submit for our advance approval your promotional materials referencing your NCQA status. Instead, we will be instituting an audit of promotional materials to ensure they comply with NCQA's Marketing and Advertising Guidelines as more fully described below for NCQA Accreditation, Certification, Recognition, Distinction and Health Insurance Plan Rankings.

The new streamlined process is described in the NCQA Marketing and Advertising Guidelines and is intended to reduce your burden when you publicize your NCQA status. The updated guidelines will be available on our Web site www.ncqa.org.

Source: NCQA

NCQA Announces Completion of ACO Pilot Tests

NCQA has announced that 10 pilot programs in its Accreditation Program for Accountable Care Organizations (ACOs) has just been completed.

NCQA will use the feedback from the pilot program to create final ACO standards, which are expected to be released in July.

For NCQA's full press release, click here:
http://www.ncqa.org/tabid/1330/Default.aspx

Groups Weigh in on NCQA's Proposed ACO Standards

The Patient Protection and Affordable Care Act requires the creation of accountable care organizations (ACOs), which are defined as "an integrated group of providers that will be held accountable for the overall cost and quality of care for a defined set of patients. Under the law, ACOs that participate in the Medicare program would continue to be reimbursed under the fee-for-service system, but they would be eligible to share in any savings below benchmark cost levels, as long as they also meet quality performance standards."

NCQA released draft standards for ACOs. Various organizations such as the Federation of American Hospitals, American Medical Group Association, and the Campaign for Better Care commented on the standards, stating that until the government establishes rules for ACOs, any draft standards are prematurely developed. The groups also urged NCQA to draft standards that are focused on quality outcomes, rather than on how an ACO should be structured.

NCQA's draft standards can be found here:
http://www.ncqa.org/tabid/1266/Default.aspx

AMGA's comments can be found here:
http://www.amga.org/Advocacy/Resources/ncqaCommentLetter.pdf

FAH's comments can be found here:
http://www.fah.org/fahCMS/Documents/On%20The%20Record/Public%20Comments/2010/NCQA_Letter_re_2011_Criteria_for_ACOs_-_final.pdf



Source: BNA

NCQA Response Regarding American Board of Pediatrics Certification Changes

NCQA was recently contacted regarding the American Board of Pediatrics' (ABP) implementation of the Maintenance of Certification (MOC) program and elimination of certification expiration dates. NCQA was asked how the change will affect scoring of pediatricians in 2010 and beyond for CR 3 Element A factor B.

NCQA provided the following response:

"We are investigating the changes in the ABMS policy to determine whether or not a change to our board certification verification requirements is appropriate. Once we have reviewed the ABMS policy, we will notify customers of any changes through the Programs section of our Web site (http://www.ncqa.org/tabid/58/Default.aspx). Any changes will be posted as a Policy Update; to access any changes, please visit the Web site provided and click on "Policy Updates and Supporting Documents" and then on "Corrections, Clarifications and Policy Changes." The next Policy Update is scheduled for March 29, 2010."

NAMSS will continue to alert the membership as more information regarding the ABP's changes becomes available.

Update to NCQA Article in March/April 2009 Synergy

In the Mar/Apr 2009 issue of Synergy, there is an update to the CE article titled, “NCQA Delegation Requirements,” by Melinda Orlando. On page 14 of her article, she says, “For a detailed explanation of NCQA’s 8/30 methodology, see www.ncqa.org/updates.”

Please note that this information has moved on the NCQA Web site to here: www.ncqa.org/tabid/125/Default.aspx. Scroll down to the bottom of the page and click on the link under 5.1.01, Explanation of "8 and 30" File Sampling Procedure.