Lance's Corner

NCQA Lists Accomplishments

Jan 24, 2025

Per the notice below, the National Committee for Quality Assurance (NCQA) has listed its 2024 accomplishments.

 
2024 was a big year for NCQA and health care quality.  Let's look back at some major milestones from 2024 and the work we’ve done to advance our mission.  We look forward to partnering with you in 2025 by providing insights, best practices and resources to help you on your quality improvement journey.
Top Resources
Health Equity Series

Empowers NCQA Accreditation customers to build infrastructure to sustain health equity initiatives beyond Accreditation.
 
Register Now ➤
Navigating Cross-Sector Partnerships
Reference Guide

 
Cross-sector partnerships are a key strategy to address health-related social needs.  Partnerships leverage the expertise and resources of each organization, and can bolster efforts to improve community health and well-being.

Download Now
Pew Charitable Trusts  Antibiotic Utilization for Respiratory
Conditions Report


Understanding variations in performance in the HEDIS suite of antibiotic measures is an opportunity to identify areas for improvement.

Read More
Digital Quality Hub 
 
We launched the Digital Quality Hub to provide the latest news, information and resources to support health care organizations in their transition to digital quality.

Learn More ➤
Most Read Articles
NCQA’s Proposed Timeline for Retiring and Replacing HEDIS Hybrid Measures

Read More ➤
Updates to Breast Cancer Screening Age Range for HEDIS MY 2025

Read More ➤
What New OMB Rules on Race and Ethnicity Mean for You

Read More ➤
NCQA Shares New Guidance for Digital
HEDIS Reporting
& Ethnicity Data


Read More ➤
What CMS’s New Interoperability Rules Mean for Quality

Read More ➤
Top Podcasts
The Move to Digital Quality Measurement
 
Rebecca takes an in-depth look at the sociotechnical shifts required for this evolution, and shares practical strategies to help organizations navigate this complex process.

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The New Rules of Data Sharing
 
Amol describes TEFCA as a voluntary national network—like the postal service—facilitating the free flow of HEDIS data.  Eric highlights its bipartisan roots in the 2016 Cures Act, showcasing TEFCA as a public-private partnership and a model for standards-based improvement.

Listen Now
The Future of HEDIS®: Better Data, Better Measures,
Better Care

 
University of Chicago professor Dr. Marshall Chin shares a comprehensive, multifaceted strategy to improve health equity. 

Listen Now
Announcements
Health Quality at NCQA
 
NCQA and Whitman-Walker jointly developed an issue brief, Empowering Health Care Organizations to Improve Care for LGBTQ+ Populations, which discusses HIPAA protections for responsible SOGI data stewardship, why understanding these regulations is important and how organizations can better serve the LGBTQ+ community. 
 
Learn More ➤
Focus on Credentialing
 
NCQA updated its Credentialing Product Suite to help ensure that organizations can maintain a high-quality network for members and clients, while providing a framework for adopting industry best practices to promote accurate and efficient verification of practitioner credentials.
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Product Launches and Updates
New and Improved Quality Compass 

This data portal gives you exclusive access to health plan performance and benchmarks to identify areas for quality improvement.
 
Learn More ➤
Virtual Care Accreditation 

This program is for organizations that offer virtual primary care and virtual urgent care, and for those that oversee virtual care networks.
 
Learn More ➤
NCQA Events
Health Quality Forum
 April 7–8
 
The NCQA Health Quality Forum explores how states and their partners are improving care for vulnerable and underserved communities, with a focus on health disparities in communities facing the greatest barriers to quality care.
 
Register Now ➤
Health Innovation Summit
October 13–15

The summit is a four-day, in-person event with sessions focused on health equity, digital measurement and more.  Join us in San Francisco, CA, in October!
 
2025: Sign up for updates! ➤
2024: View Highlights ➤
Top Education Courses
Race, Ethnicity, SOGI, Income and Language in Patient Registration

Register Now
SOGI Data LGBTQ+ Health Care: Quality

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PCMH Recognition Annual Reporting 2025: Continued Success

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Harnessing the Power of Diagnostic Data to Support CM, QI

Register Now
Introduction to HEDIS®

Register Now
Using Goal Attainment Scaling

Register Now

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc