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.
Appears in 4 contracts
Samples: Baseline Provider Agreement, Baseline Provider Agreement, Baseline Provider Agreement
