Common use of National Committee for Quality Assurance Accreditation Clause in Contracts

National Committee for Quality Assurance Accreditation. The MCO must hold and maintain or must obtain National Committee for Quality Assurance (NCQA) Health Plan accreditation, for the MCO’s Ohio Medicaid line of business. If the MCO does not have NCQA Health Plan accreditation for the MCO’s Ohio Medicaid line of business as of the effective date of this Agreement, the MCO must achieve NCQA Health Plan accreditation within 18 months of the effective date of this Agreement. The MCO must achieve and maintain a minimum status of “Accredited.” If the MCO receives a “Provisional” or “Denied” status from NCQA, the MCO will be subject to sanctions as specified in Appendix N, Compliance Actions. ODM will assess MCO compliance annually, based on the MCO’s accreditation status posted on the NCQA “Report Cards” webpage (xxxxx://xxxxxxxxxxx.xxxx.xxx/) as of November 1 of each year. For the purposes of determining whether the MCO meets this accreditation requirement, ODM will only accept the use of the NCQA Corporate Survey Process to the extent deemed allowable by NCQA. Upon ODM’s request, the MCO must provide requested documents related to NCQA accreditation within the timeframe specified by ODM.

National Committee for Quality Assurance Accreditation. i. The MCO entity contracting with ODM as the OhioRISE Plan must hold and maintain maintain, or must obtain be in the process of obtaining National Committee for Quality Assurance (NCQA) Health Plan accreditationaccreditation from the date of the contract, for the MCO’s OhioRISE Plan's Ohio Medicaid line of business. If the MCO does not have NCQA Health Plan accreditation for the MCO’s Ohio Medicaid line of business as of the effective date of this Agreement, the MCO must achieve NCQA Health Plan accreditation within 18 months of the effective date of this Agreement. ii. The MCO OhioRISE Plan must achieve and maintain a minimum status of “"Accredited.” " If the MCO OhioRISE Plan receives a “"Provisional” " or “"Denied” " status from NCQA, the MCO OhioRISE Plan will be subject to sanctions as specified noted in Appendix N, Compliance Actions. iii. ODM will assess MCO OhioRISE Plan compliance annually, based on the MCO’s OhioRISE Plan's accreditation status posted on the NCQA “"Report Cards” " webpage (xxxxx://xxxxxxxxxxx.xxxx.xxx/) as of November 1 of each year. iv. For the purposes of determining whether the MCO OhioRISE Plan meets this accreditation requirement, ODM will only accept the use of the NCQA Corporate Survey Process to the extent deemed allowable by NCQA. . v. Upon ODM’s 's request, the MCO OhioRISE Plan must provide requested documents related to NCQA accreditation within the timeframe specified by ODM.

National Committee for Quality Assurance Accreditation. i. The MCO must hold and maintain maintain, or must obtain National Committee for Quality Assurance (NCQA) Health Plan accreditationaccreditation by the next available accreditation cycle, for the MCO’s 's Ohio Medicaid line of business. If the MCO does not have NCQA Health Plan accreditation for the MCO’s Ohio Medicaid line of business as of the effective date of this Agreement, the MCO must achieve NCQA Health Plan accreditation within 18 months of the effective date of this Agreement. ii. The MCO must achieve and maintain a minimum status of “"Accredited.” " If the MCO receives a “"Provisional” " or “"Denied” " status from NCQA, the MCO will be subject to sanctions as specified in Appendix N, Compliance Actions. iii. ODM will assess MCO compliance annually, based on the MCO’s 's accreditation status posted on the NCQA “"Report Cards” " webpage (xxxxx://xxxxxxxxxxx.xxxx.xxx/) as of November 1 of each year. iv. For the purposes of determining whether the MCO meets this accreditation requirement, ODM will only accept the use of the NCQA Corporate Survey Process to the extent deemed allowable by NCQA. . v. Upon ODM’s 's request, the MCO must provide requested documents related to NCQA accreditation within the timeframe specified by ODM.