News and Commentary

NCQA To Help CMS Monitor Quality of M+C Plans


The National Committee for Quality Assurance has been tapped to help the Centers for Medicare and Medicaid Services (formerly HCFA) monitor plans that participate in Medicare+Choice.

NCQA has been granted so-called "deeming authority" for the M+C program.

Margaret O'Kane, NCQA president, says that this means that plans can satisfy many of their M+C requirements during an NCQA accreditation survey.

"It's a more efficient approach to oversight that will allow health plans to focus more energy on their core business," says O'Kane.

Under the contract, NCQA will review M+C plans in these categories: access to services, antidiscrimination, confidentiality and accuracy of enrollee records, information on advance directives, provider participation rules, and quality assurance.

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