Why the Public Comment Period that Closes Monday is Different

January 8, 2024 · Andy Reynolds

Two unusual features distinguish the NCQA public comment period that closes January 15.

These unique aspects mean participating in public comment is a valuable opportunity for readers like you to shape quality’s future.

The first difference between this and other public comment opportunities is the large number of programs under consideration: six!

• Credentialing Accreditation and Credentialing Verification Organization Certification.
• Health Equity Partner Certification (New).
• Health Plan Accreditation.
• Health Plan Ratings.
• Managed Behavioral Health Organization Accreditation.
• Utilization Management Accreditation.

If you’re used to commenting on one or two NCQA programs at a time, giving input on six programs is a clear, empowering difference.

The second feature that sets this public comment period apart: The credentialing programs that are part of public comment have downstream effects.

Credentialing’s Broad, Deep Impact

Our rules for credentialing pervade three programs:

• Health Plan Accreditation (currently: more than 1,200 organizations).
• Credentialing Accreditation (currently: almost 200 organizations).
• Credentials Verification Organization Certification (currently: more than 100 organizations).

Credentialing also affects the availability of care. That’s because credentialing affects how care gets billed. Providers can’t bill if they haven’t met credentialing requirements.

We think our ideas for credentialing will improve access and quality in the following way:

1. Our proposed standards will make for faster credentialing.
2. Faster credentialing means organizations can bill.
3. Being able to bill helps providers open access to care so more patients get the care they need.

Changes We Propose for Credentialing

Our ideas we’ve outlined in public comment include:

• Consolidating Programs. We suggest combining Credentialing Accreditation and Credentials Verification Organization into one program. We’d offer options for individual certifications (e.g., State Licensing Certification) or an overall Credentialing Accreditation.
• Bigger Role for Credentialing Committees. We propose expanding Credential Committees’ responsibilities to include reviewing sanctions, complaints and other adverse events found during ongoing monitoring.
• Tech-Enabled, Faster Verification. Since technology improvements have made verification faster, we want to shorten our expectations for how long verification should take.

In Short

• Use public comment to tell us what you think of our ideas.
• The public comment period that closes January 15 is your chance to give feedback on a diverse range of NCQA suggestions.
• Due to ripple effects of our credentialing programs, the changes we’ve proposed to those programs mean this public comment opportunity is special.