CMS approves national committee to accredit Medicare + Choice organizations

     The Centers for Medicare and Medicaid Services recently approved the first non-governmental agency for deeming authority of Medicare+Choice organizations that are licensed as HMO's, reducing administrative burden and making it easier for health plans to serve Medicare beneficiaries.

      CMS has found that the National Committee on Quality Assurance's standards for Medicare managed care organizations meet or exceed those established by the Medicare program.  The Balanced Budget Act of 1997 directed CMS to establish and oversee a program that allows private, national accreditation organizations to "deem" that a Medicare+Choice organization meets certain Medicare requirements.

     Medicare+Choice organizations that are licensed as HMOs and are accredited by NCQA may receive, at their request, deemed status for Medicare+Choice requirements in six areas:  Quality Assurance, Information on Advance Directives, Antidiscrimination, Access to Services, Provider Participation Rules, and Confidentiality and Accuracy of Enrollee Records.  NCQA submitted its application to be considered for deeming authority to CMS in April 2001 and two other applications are currently pending.