FAQ Directory: Health Plan Accreditation

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9.15.2018 Terminated arrangements more than 90 calendar days before submission If an organization terminated an arrangement with an NCQA-Accredited/Certified/Recognized delegate more than 90 calendar days before it submitted the completed survey tool, is the organization eligible for automatic credit for the portion of the look-back period when activities were performed by the delegate?

Yes. For non-file review requirements, if the arrangement was terminated more than 90 calendar days before submission of the completed survey tool, the organization is eligible for automatic credit for the portion of the look-back period when the NCQA-Accredited/ Certified/Recognized delegate conducted activities. For file review requirements, automatic credit is applied if the delegate processed (or handled) the file, regardless of when the delegation arrangement was terminated.

HP 2019

8.29.2018 What is the Health Plan Medicaid Module?

NCQA Health Plan Medicaid Module is a complementary program designed to support NCQA-Accredited health plans with a Medicaid product line. The combination of the module standards and NCQA Health Plan Accreditation maximize alignment with the Medicaid Managed Care program requirements. This improves a plan’s opportunity to receive a streamlined state compliance review.

NCQA developed the module by analyzing changes to state and federal requirements for the Medicaid Managed Care programs, as outlined in the Medicaid Managed Care Rule.

HP 2020

8.24.2018 What is the price for the LTSS Distinction for Health Plans?

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

HP 2020

8.24.2018 What is the price for the Medicaid Module Survey?

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

HP 2020

8.24.2018 Where can I find the Medicaid Module Standards and Guidelines? How can I obtain the Medicaid Module Standards and Guidelines?

8.24.2018 What is the price for Health Plan Accreditation?

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

HP 2020

8.24.2018 What other health plans have earned LTSS Distinction?

8.24.2018 Where can I find information to help me get started with Health Plan Accreditation?

8.24.2018 What is the process for meeting Module requirements?

The first step is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.

Align your organization’s processes with the standards. NCQA conducts the survey and provides results within 30 days of the final review.

See a step-by-step process.

HP 2020

8.24.2018 How long does it take to earn LTSS Distinction for Health Plans?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

HP 2020

8.24.2018 How do I get started with the Medicaid Module?

If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.

HP 2020

8.24.2018 How do I get started with LTSS Distinction for Health Plans?

If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.

HP 2020