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New York State PCMH (NYS PCMH): Process for Getting Recognized 

Process for Transitioning to NYS PCMH Recognition For Practices that have earned PCMH 2014 Level 3

To renew your PCMH Recognition under the NYS PCMH program you will follow the Annual Reporting process.You will attest to some policies and procedures and submit data to NCQA. This means submitting evidence via documentation or providing measurement data. Annual Reporting will sustain your practice’s recognition and help you foster continuous improvement.

Step Description Time Before Recognition
Learning the NYS PCMH Annual Reporting Requirements Download the NYS PCMH Annual Reporting Requirements needed to sustain your PCMH Recognition. Requirements change from year to year. Be sure to download the requirements for the year of your first Annual Report.
6-9 months
Determine which Annual Reporting requirements you want to submit for  Ensure your practice is aligned with the Annual Reporting requirements. You will attest to continuing to meet the current PCMH requirements without providing the evidence required of practices seeking recognition for the first time. You will also show evidence you meet the additional NYS PCMH required criteria and submit key data and documentation to verify that your practice meets the core features of the medical home. 6-9 months
Find a Transformation Assistance Contractor New York offers Transformation Assistance Contractors to support your practice at no cost to your organization. Find a list of contractors here.
6-9 months
Log into Q-PASS You will need to claim your organization in Q-PASS to get started. Please note: Multi-site accounts should contact NCQA in advance through My NCQA. 4 months
Update/confirm organization information Update/confirm organizational information in Q-PASS. In Q-PASS you can update clinician information, contact information, change addresses and add users to your account. 4 months
Enroll through Q-PASS This starts the Annual Reporting process. Please be sure to have your required code to enroll in NYS PCMH.  If you were part of New York’s Advanced Primary Care program, request this code from a Technical Assistance Contractor. If you were not part of New York's APC program, your code is "GNYDOC". NOTE: Enroll at least 3 months prior to your recognition expiration date. All Annual Reporting requirements (data and documentation) must be submitted no later than 30 days prior to your recognition expiration date. 3+ months
Connect with Your NCQA Representative You will be assigned an NCQA Representative who will be available to assist you with educational resources and answers to your questions. 3 months
Upload Evidence Demonstrate that you are embracing measurement and quality improvement. Submit documentation and data via Q-PASS. 1+ months
NCQA Review NCQA reviews documentation and notifies practice of their sustained recognition status. 1 month
Earn Recognition NCQA notifies your practice of its NYS PCMH Recognition status. 0 months
Print Your Recognition Certificate Once notified of recognition, go into Q-PASS and print Recognition Certificate (from the My Evaluation screen in Q-PASS). 0 months
Annual Reporting Your practice performs ongoing quality improvement and submits evidence of this during Annual Reporting to sustain NCQA recognition and succeed as a NYS PCMH. 11 months after your recognition date (1 month prior to anniversary date)