On Tuesday, March 24, 2020, the National Committee for Quality Assurance (NCQA) enacted policies for NCQA staff, contractors, and events, based on updates from the CDC and other authorities. Please find information regarding changes affecting PCMH/PCSP Recognition programs as a response to the Coronavirus national emergency below:

  • Is prepared to conduct all business activities virtually if needed
  • Will continue to deliver all systems, surveys, support services, contract, and grant related services
  • Is assessing large meetings, events, and conferences with the goal to convert to virtual events

Practitioners Who Provide Care During a Public Health Emergency

  • Organizations don’t need to credential practitioners who are not part of their network or practice and are providing care to members/patients as part of a federal, state, or local government emergency response team.
  • Organizations don’t need to credential practitioners part of the organizations emergency response efforts if it documents disaster management plans implemented from March – September for allowing these practitioners to provide care for members.

CMS 1135 Waivers for State Licensing

  • CMS allows states to request a waiver that temporarily allows out of state practitioners to provide services licensed in another state. When credentialing practitioners in a state that receive a waiver, NCQA will waive the requirement that organizations verify the license to practice for that state.

Health Care Organizations & Practices Whose Operations are Affected

  • NCQA will be flexible in scoring organization performance during the March – September time frame. Organizations will need to provide documentation regarding the circumstances that interfered with meeting requirements.
  • Practices may show evidence from any time in the past year, so organizations may demonstrate activities were implemented before and after the March – September time frame.
  • Organizations with an upcoming survey or evaluation in 2020 should contact their Recognition account representative. NCQA will determine if additional accommodations (e.g., longer extensions, virtual surveys, shorter look-back periods) are necessary on a case-by-case basis.

NCQA will continue to assess the situation and will make updates as needed. For further information and updates: NCQA COVID-19

HERE is a one pager with this NCQA information for your reference.

Contact us at Kentucky REC with your questions. We’re here to help and are available at 859-323-3090.