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Virginia, DC Medicaid programs expand

Credentialing Resource Center Connection, August 18, 2005

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Virginia and Washington, DC will now require health plans participating in Medicaid to adopt NCQA standards and measures as a means of improving quality oversight.

All Virginia Medicaid managed care plans must hold NCQA Accreditation or be reviewed by the end of the year, an effort that began on July 1. Currently six out of eight Virginia Medicaid plans hold NCQA accreditation.

Washington, DC Medicaid plans will be required by the Department of Health to report 41 HEDIS measures, including those assessing cancer, diabetes, and asthma care. HEDIS performance measures are designed to make sure purchasers and consumers have the information they need in order to compare the performance of managed health care plans. This change will affect some 142,000 Medicaid beneficiaries and three major Medicaid plans.

For more information on these changes, see the NCQA official web site at http://www.ncqa.org/Communications/News/Virginia_DC.htm.

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