The Centers for Medicare and Medicaid Services is poised to deem a third organization as a recognized accreditation entity to certify qualified health plans as eligible to market their coverage on health insurance exchanges.
CMS previously recognized NCQA and URAC as accrediting entities for qualified health plans. Now, it has concluded that the Accreditation Association for Ambulatory Health Care, which already accredits ambulatory surgery centers and has approval to accredit Medicare Advantage plans, also is an appropriate entity to accredit qualified health plans under the HIX program.
But first, CMS seeks public comment in a notice available here before finalizing its decision. “Upon completion of our analysis, including evaluation of comments received as a result of this notice, we will publish a final notice in the Federal Register announcing the result of our determination.”
CMS in the notice lists 40 clinical quality measures that AAAHC would use for assessing health plan accreditation, covering preventive care, behavioral health and substance abuse disorders, chronic care and acute care.
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