NCQA Accreditation. As applicable in the performance of the Agreement, Provider is subject to all applicable accreditation standards (e.g., National Committee for Quality Assurance (“NCQA”) accreditation), as may be set forth in the Agreement and any applicable attachments thereto.
NCQA Accreditation. The ICDS Plan must hold and maintain, or must be actively seeking and working towards, accreditation by the National Committee for Quality Assurance (NCQA) for the Ohio Medicare or Medicaid line of business. The ICDS Plan must achieve and/or maintain an excellent, commendable or accredited status from NCQA. For the purposes of meeting this accreditation requirement, ODM will only accept the use of the NCQA corporate survey to the extent deemed allowable by NCQA. Upon completion of the accreditation survey, the ICDS Plan must submit to ODM a copy of the “Final Decision Letter” no later than ten (10) calendar days upon receipt from NCQA. Thereafter and on an annual basis between accreditation surveys, the ICDS Plan must submit a copy of the “Accreditation Summary Report” issued as a result of the annual HEDIS update no later than ten (10) calendar days upon receipt from NCQA. Upon ODM’s request, the ICDS Plan must provide any and all documents related to achieving accreditation.
NCQA Accreditation. 2.15.6.1 The CONTRACTOR shall obtain NCQA accreditation by November 30, 2009 and shall maintain it thereafter. Any accreditation status granted by NCQA under the New Health Plan (NHP) program or the MCO Introductory Survey option will not be acknowledged by TENNCARE. Accreditation obtained under the NCQA Full Accreditation Survey or Multiple Product Survey options will be acknowledged by TENNCARE if the TennCare product is specifically included in the NCQA survey. TENNCARE will accept the use of the NCQA Corporate Survey process, to the extent deemed allowable by NCQA, in the accreditation of the CONTRACTOR. In order to ensure that the CONTRACTOR is making forward progress, TENNCARE shall require that the following information and/or benchmarks be met: REQUIRED EVENT DEADLINE CALENDAR YEAR 2007 NCQA Accreditation Survey Application Submitted and Pre Survey Fee paid December 15, 2007 CALENDAR YEAR 2008 Submit copy of signed NCQA Survey contract to TENNCARE January 15, 2008 Purchase NCQA ISS Tool for 2009 MCO Accreditation Survey August 15, 2008 Copy of signed contract with NCQA approved vendor to perform 2009 CAHPS surveys (Adult, Child and Children with Chronic Conditions to TENNCARE) November 15, 2008 Copy of signed contract with NCQA approved vendor to perform 2009 HEDIS Audit to TENNCARE (The CONTRACTOR must perform the complete Medicaid HEDIS Data Set with the exception of dental related measures) November 15, 2008 CALENDAR YEAR 2009 Notify TENNCARE of date for ISS Submission and NCQA On-site review January 15, 2009 HEDIS Baseline Assessment Tool completed and submitted to Contracted HEDIS Auditor, TENNCARE, and the EQRO February 15, 2009 Audited Medicaid HEDIS and CAHPS results submitted to NCQA and TENNCARE June 15, 2009 Finalize preparations for NCQA Survey (Final payment must be submitted to NCQA sixty (60) calendar days prior to submission of ISS) Notify TennCare of final payment within five (5) business days of submission to NCQA. REQUIRED EVENT DEADLINE Submission of ISS to NCQA Notify TennCare within five (5) business days of submission to NCQA. NCQA Survey Completed and copy of NCQA Final Report to TENNCARE: November 30, 2009 • Excellent, Commendable, or Accredited • Provisional – Corrective Action required to achieve status of Excellent, Commendable, or Accredited; resurvey within twelve (12) months. • Accreditation Denied – Results in termination of this Agreement.
NCQA Accreditation. 7.4.1 The Contractor shall maintain NCQA accreditation at a level of “accredited” or better.
NCQA Accreditation. CONTRACTING PROVIDER agrees that if, during the term of this Agreement, NCQA develops criteria or standards for the accreditation of eye care organizations, then CONTRACTING PROVIDER shall use good faith efforts to obtain such accreditation. If CONTRACTING PROVIDER fails to secure such NCQA accreditation, following formal NCQA review, then Anthem BC&BS shall have the right to terminate this Agreement pursuant to Section 8.4 (b) hereof.
NCQA Accreditation. Cimarron Health Plan, the Company’s subsidiary operating in New Mexico as a health maintenance organization (the “HMO Subsidiary”), is currently accredited by the National Committee for Quality Assurance (the “NCQA”) with a “commendable” rating for both its commercial and Medicaid lines of business. The Company previously has delivered to Acquiror true, correct and complete copies of the HMO Subsidiary’s most recent NCQA accreditation survey report and recommendations, if any. The Company and the HMO Subsidiary have taken all reasonable steps to address the recommendations as appropriate as described on Schedule 4.26 attached hereto. The most recent such NCQA accreditation survey report resulted in continued NCQA accreditation of the HMO Subsidiary for a period of up to three years.
NCQA Accreditation. If the Contractor intends to continue provision of contracted managed care services for the HCA past December 31, 2014, the Contractor must provide evidence of application for NCQA certification for Medicaid no later than September 30, 2014. Such evidence may be application documents with verification from the NCQA that the application process has begun. If the Contractor is already NCQA certified for Medicaid, the Contractor shall submit its current NCQA accreditation certificate for Medicaid to HCA no later than September 30, 2014.
