The Centers for Medicare and Medicaid Services has selected the National Committee for Quality Assurance as an accrediting entity for insurers participating in health insurance exchanges authorized under the Affordable Care Act.

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.”

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access