The selection expands NCQA’s scope as it already accredits health plans for other purposes. The organization has developed an Exchange Add-on Survey, which is a streamlined approach for commercial, Medicare and Medicaid payers already accredited under NCQA. Insurers that will administer their insurance exchange product line in the same manner as an existing NCQA-accredited product line can be accredited for the exchange without conducting a formal survey.
If an insurer attests that it will include in an exchange product at least 70 percent of the elements scored by NCQA in a currently accredited product, the plan will receive auto-accreditation, according to a frequently asked questions document on exchange accreditation available here.
“If an organization does not qualify for auto-accreditation for its Exchange product line, NCQA will survey those elements that it will administer differently using NCQA’s existing add-on survey process,” according to the organization. “The survey will only consist of the off-site portion of the survey process and will not include a file review.”