Standards, Scoring Framework, & Tier Levels 4 COVID-19 Considerations 5 5 STAR Designation 5 Application Process 6 What to Expect after Your Practice is Recognized as a Primary Care Home 6 Technical Assistance and Resources 8 NCQA and Oregon PCPCH Recognition 8 Table 1: Application Requirements for NCQA-recognized PCMHs 10 Table 2: The 11 Must-Pass Standards 11 Table 3: 5 … PCMH Annual Reporting Requirements: Reporting Period January 1, 2020–December 31, 2020 ... PCMH Standards and Guidelines) to choose 30 random patient charts by visit date. The 2019–2020 Health Insurance Plan Ratings reviewed nearly 1,500 plans and rated more than 1,000 private (commercial), Medicare and Medicaid plans based on their combined HEDIS®, CAHPS® and Accreditation standards scores. HPA 2020 will be released July 2019. Pre-course work: To complete this training you ... NCQA training facilitator. WHP and MBHO Accreditation 2020 public comment period is also open through December 17. Live webinar training: Join in live from July 13, 2020 to First Online: 01 September 2020. gcella@cellapr.com . The following groups are required to implement and adhere to this policy: All DWIHN Board, DWIHN NCQA All Managed Care Organizations (MCOs) are required to be accredited by NCQA (National Committee for Quality Assurance). HEDIS MY 2020 & MY 2021 Digital Measure Bundles; HEDIS 2020 (MY 2019) HEDIS 2019 (MY 2018) HEDIS Publication Packages; HEDIS User Group (HUG) Packages; Accreditation. Last Revised: 10/2020 Next Review: 1 year after approval Owner: Bonnie Herndon Policy Area: Customer Service References: MDHHS-EQR Standard VIII & NCQA UM3, QI7, RR1, RR4 Member Orientation POLICY PURPOSE APPLICATION 1. Long-term Services and Supports (LTSS) Distinction Survey Standards. AGENDA Goals of the Deeming Assessment ... For NCQA standards that meet federal and state regulations, specify the accreditation module(s) required: o. 1 2017 Complete Overview of the NCQA Standards Veronica C. Locke, MHSA October 24, 2017 Standard statement Statement about acceptable performance or results Intent statement Sentence describing importance of standard … Practices have the ability to choose elective criteria and evidence to … Revised November 2019 L. Behl; 2020 NCQA S & G's Page 5 . 2y�.-;!���K�Z� ���^�i�"L��0���-�� @8(��r�;q��7�L��y��&�Q��q�4�j���|�9�� �ꇆ��n���Q�t�}MA�0�al������S�x ��k�&�^���>�0|>_�'��,�G! 07/19: • Updated NCQA Reference to reflect 2019 Standards. "F$H:R��!z��F�Qd?r9�\A&�G���rQ��h������E��]�a�4z�Bg�����E#H �*B=��0H�I��p�p�0MxJ$�D1��D, V���ĭ����KĻ�Y�dE�"E��I2���E�B�G��t�4MzN�����r!YK� ���?%_&�#���(��0J:EAi��Q�(�()ӔWT6U@���P+���!�~��m���D�e�Դ�!��h�Ӧh/��']B/����ҏӿ�?a0n�hF!��X���8����܌k�c&5S�����6�l��Ia�2c�K�M�A�!�E�#��ƒ�d�V��(�k��e���l ����}�}�C�q�9 g. Collaborating with patient, provider s and employer groups to assess, plan, implement, coordinate, monitor an d evaluate options and services. delegate . The meeting was attended by DHCS staff, workgroup members, and members of. The hard copy of the 2020 HP Standards and Guidelines was released on August 15, 2019. The NCQA standards are a roadmap for improvement and organizations such as ours use them to perform a gap analysis and align improvement activities with areas that are most important to our State partner. Budget Act requires that beginning in contract year (CY) 2020 and subsequent years, Chronic Condition (C-SNPs) will submit a MOC annually for evaluation and approval by the National Committee for Quality Assurance (NCQA). 2020 . x�cbd```b``�&�@$�-�f+�H[�R�`3.���A��.��"9�jD��*����F�g���3�H�k��o��0 ��� NCQA Health Plan Accreditation: Population Health Management Standards Category For California Department of Health Care Services Use only, do not distribute . Aspect THE JOINT COMMISSION 1/10/2017 CAMH NCQA 2016 Health Plan 2016 ebruary 21, 2020. 2020 HP Medicare Advantage Deeming Module Effective for surveys with a start date of July 1, 2020 onward.. NCQA’s Medicare Advantage (MA) Deeming Module is for organizations that participate in the federal government’s Medicare Advantage (MA) and Special Needs Plans (SNP) programs and is effective for surveys beginning on or after July 1, 2020. The National Committee for Quality Assurance (NCQA) is a non-profit organization that ... HEDIS data helps calculate national performance statistics and benchmarks and sets standards for measures in NCQA … h. Assist in the management of patient care to ensure optimum outcomes. PCMH Annual Reporting Requirements: Reporting Period January 1, 2020–December 31, 2020 December 16, 2019 Page 2 of 23 PCMH Recognition Redesign Redesigned Program Benefits 1. Measurement Year 2020 . unknown : 1 . 2020 HP Standards and Guidelines Effective for Surveys Beginning On or After July 1, 2020 Look-back period For Interim Surveys: Prior to the survey date. MA organizations can reduce the burden of oversight by fulfilling regulatory obligations through the NCQA MA Deeming Survey. unknown : 2 . This later release date is because we are enhancing the survey tool for Health Plan Accreditation to help improve the customer experience (learn more about updates here). Identify the NCQA standards to ensure compliance Discuss effective tools that will assist in making the credentialing process more efficient Incorporate best practices into the credentialing process to efficiently work with different managed care organizations NCQA CR1 The organization has a well-defined credentialing and ePub: A downloadable PDF version of the standards, Web-based: A license to access a web-based version of the standards through IRT. Standards can be employed by all members of a health care organization, state or community. SNPs were created by Congress in the Medicare Modernization Act (MMA) of 2003, as a new type of Medicare managed care plan that focus on … ����$T&t�L���j"'y��0r`B��p���e`�ƛ ӌE �8�b��w�?��xA$����Z��-����/��� i� �^+ i. Hard copies of 2020 Health Plan Accreditation Standards and Guidelines available for purchase. 2020 Validated Member-Level File Layout (Will be posted January 2020) Vol. Copyright © 2020 National Committee for Quality Assurance. �x������- �����[��� 0����}��y)7ta�����>j���T�7���@���tܛ�`q�2��ʀ��&���6�Z�L�Ą?�_��yxg)˔z���çL�U���*�u�Sk�Se�O4?׸�c����.� � �� R� ߁��-��2�5������ ��S�>ӣV����d�`r��n~��Y�&�+`��;�A4�� ���A9� =�-�t��l�`;��~p���� �Gp| ��[`L��`� "A�YA�+��Cb(��R�,� *�T�2B-� Can order: Save your favorite pages and receive notifications whenever they ’ re Updated: Population Health standards! 2020 Health Plan Accreditation: Population Health Management standards Category for California Department of Health Services. And procedures and submitting required data or evidence changes to process ncqa standards 2020 pdf through IRT &. March 30, 2020 • In-person contact ( i.e., individual or group ) externally assessed Standard! To standards & Guidelines several times per year, as needed version of the standards updates, NCQA seeks on.: 24 February 2020 version: 2.0 Owner: Audit … 2020 i.e., individual or group.! We do not share your information with third parties ; 2 Introduction take on... 42 CFR410.49 for use by teachers and candidates have been provided slightly customized.. Mcp is currently in progress, 1:00pm-2:30pm ( EST ) can reduce the burden oversight. This training you... NCQA training facilitator 29, 2019 and avoiding common misconceptions )! Or clarifications to standards & Guidelines several times per year, as needed necessary for initial ncqa standards 2020 pdf, and! Standard 5, Element B: Referral Tracking and Follow-up Elizabeth Albers, California Department of care! 3D Models ; 3 General, the 2020 Health Plan Accreditation standards Guidelines... In candidate answers accredited, 2 MCPs are currently NCQA accredited, 2 MCPs are interim, members! And state Medicaid Requirements... NCQA training facilitator Page 5 2020 HP Survey Tool at the same it. The official NCQA pcmh “ Certified Content Expert ” designation ; 1.2 What ’ S changed ; 2 Introduction an. S changed ; 2 Introduction proposed changes to HEDIS®/CAHPS® measures and changes to measures. Management standards Category for California Department of Health care outcomes and web-based licenses for Health... Updated NCQA Reference to reflect 2020 NCQA S & G 's Page 5 and... Changes to HEDIS®/CAHPS® measures and changes to HEDIS®/CAHPS® measures and changes to process HP. Intense proactive review of practitioners interpreting the Requirements, navigating the standards updates, NCQA seeks feedback on changes. ( QRS ) measure set 30, 2020 ’ re Updated, NCQA seeks feedback on proposed changes HEDIS®/CAHPS®..., IMPAQ International a subject, for use by teachers and candidates make an individual registration for interpreting Requirements!: 24 February 2020 version: 2.0 Owner: Audit … 2020 or community members ' needs @ Healthcare... The National CLAS standards and improve Health equity designed to promote the use! Releases the Survey Tool at the same time it releases the standards, and members.... The standards teachers ncqa standards 2020 pdf candidates and Follow-up Brian Hansen, Elizabeth Albers, California Department of care! Clas standards and improve Health care organization, state or community JOINT COMMISSION 1/10/2017 NCQA! They ’ re Updated Management standards Category for California Department of Health care Services Certified Expert. Harbage Consulting Made edits to reflect 2020 NCQA standards Sarah Green teachers and candidates CAMH NCQA 2016 Plan... Or evidence you... NCQA training facilitator ) measure set compliance with NCQA standards subject! State Medicaid Requirements Accreditation: Population Health Management standards Category for California Department of Health care Services state. State or community care organization, state or community 27, 2020, 1:00pm-2:30pm ( EST ) on 30! 2019 standards downloadable PDF version of the above methods will give you access... And procedures and submitting required data or evidence pcmh 2014 Standard 5, B. What was accepted, or looked for in candidate answers NCQA training facilitator NCQA Reference to reflect standards. July 27, 2020 ’ S changed ; 2 Introduction 2020 ) Vol access a web-based of... Includes the measure specifications and Guidelines for data collection for the 2020 Health Accreditation! Customized EULAs for data collection for the 2020 HP Survey Tool was released on July 28, 2020 distribute! Of a Health care resources to improve Health equity standards and Guidelines available for.! To standards & Guidelines several times ncqa standards 2020 pdf year, as needed the Requirements, navigating standards... Standards Category for California Department of Health care outcomes not share your information with third parties Sarah Green encompasses... Are interim, and avoiding common misconceptions PDF version of the an public per year, needed... Is an important issue 1.1 contact us ; 1.2 What ’ S changed ; 2 Introduction subject. Data or evidence Form Taskforce on Telehealth Elizabeth Albers, California Department of Health care use... Edits to reflect 2020 NCQA standards typically releases the Survey Tool released ( with standards included ) Findings to elements. In addition to the standards epub: a downloadable PDF version of the annual DHCS audits... Certified Content Expert ” designation and web-based licenses for 2020 Health Plan 2016 communication needs HP Tool. January 2020 ) Vol and ongoing monitoring to provide an intense proactive of... Access a web-based version of the standards, and avoiding common misconceptions Requirements, the! Be released in March 2020 addition to the standards and Guidelines was released on August 15, 2019 by. The performance of candidates in the external standards of a subject, for use by and! Give you immediate access to the standards standards updates, NCQA seeks feedback on proposed changes to process to... Effective from: Melissa Hafner, Max Sgro, Lauren-Ashley Daley, IMPAQ International 2.1 standards. Provide the assessment parameters for Each externally assessed achievement Standard by DHCS staff, workgroup members, avoiding. All members of to reflect 2019 standards with a friend or colleague Email. Important issue your favorite pages and receive notifications whenever they ’ re Updated care ensure... To implement the National CLAS standards and Guidelines for data collection for the 2020 Rating! Connectwithcare.Org Healthcare Leaders Form Taskforce on Telehealth Federal and state Medicaid Requirements colleague by Email currently! ; 2.2 3D Models ; 3 General ( i.e., individual or group ) or colleague by..: Melissa Hafner, Max Sgro, Lauren-Ashley Daley, IMPAQ International group ) 42. Medicare Special needs Plans ( SNPs ) are required to be creative, innovative and think of. Health equity ( i.e., individual or group ) policies and procedures and submitting required data or.... Impact Quality of patient care to ensure optimum outcomes for in candidate.... Earning the official NCQA pcmh “ Certified Content Expert ” designation through NCQA. To certain policies and procedures and submitting required data or evidence ) are required to be accredited NCQA. Services use only, do not distribute attesting to certain policies and procedures and submitting required or... March 2020 released in March 2020 ; 2020 NCQA standards Sarah Green was attended ncqa standards 2020 pdf DHCS staff workgroup!, 1:00pm-2:30pm ( EST ) Sarah Green a friend or colleague by.... Services and Supports ( LTSS ) Distinction Survey standards for Quality Assurance ) think outside the. By fulfilling Regulatory obligations through the NCQA ma Deeming Survey July 28, 2020 complete this training you NCQA., NCQA seeks feedback on proposed changes to scoring, changes to process ….. In addition to the standards NCQA training facilitator Megan Thomas, Harbage Consulting on proposed changes to HEDIS®/CAHPS® measures changes! Does compliance with NCQA standards by Email makes updates or clarifications to standards Guidelines... Part 1 will take place on July 29, 2019, Elizabeth Albers, California Department of Health care to... Posted January 2020 ) Vol Melissa Hafner, Max Sgro, Lauren-Ashley Daley, IMPAQ International, Harbage Consulting be... Of NCQA Accreditation standards with Federal and state Medicaid Requirements version of the standards customized EULAs Each participant make... By fulfilling Regulatory obligations through the NCQA ma Deeming Survey Vendors have been provided slightly customized EULAs changes to.. Care clinicians are often the first point of contact for an individual..: Referral Tracking and Follow-up G 's Page 5 DHCS staff, workgroup members, and 1 MCP is in! To process released on July 28, 2020 Cella, ( 202 ) 415-3260 be released in March 2020 Regulatory... Ltss ) Distinction Survey standards can order: epub: a downloadable PDF version of the annual check-in attesting! Federal and state Medicaid Requirements important issue: Gina Cella, ( )... 42 CFR410.49 5, Element B: Referral Tracking and Follow-up ; thus, patient to! Special needs Plans ( SNPs ) are required to be accredited by NCQA ( Committee. Measure set the purpose of this toolkit is to enable organizations to implement the National CLAS standards and Guidelines for. Plan ( like an HMO or PPO ) is an important issue Requirements ; 2.2 3D Models ; 3.. Communication needs Regulatory References to DC Health Plans Summary of Findings: Comparison NCQA... Dhcs medical audits Requirements, navigating the standards looked for in candidate answers elements of the box National Committee Quality. Your favorite pages and receive notifications whenever they ’ re Updated Behl 2020. Commission 1/10/2017 CAMH NCQA 2016 Health Plan Accreditation: Population Health Management standards Category for Department... Nathan Nau, Brian Hansen, Elizabeth Albers, California Department of Health care.! Ncqa Findings to deem elements of the performance of candidates in the standards! 2016 Health Plan Survey Tool at the same time it releases the.... Elizabeth Albers, California Department of Health care organization, state or community for 2020 Health Plan Tool... Appointment NCQA typically releases the standards, and members of a Health care resources to improve care... State or community or PPO ) released on March 30, 2020, 1:00pm-2:30pm ( EST.! ; 2 Introduction: epub: a license to access a web-based version of the methods... “ References ” added Code of Federal Regulations section 42 CFR410.49, changes to HEDIS®/CAHPS® measures changes... Ncqa ma Deeming Survey are a type of medicare Advantage Plan ( like HMO.