The National Committee for Quality Assurance (NCQA) and URAC may get the job of deciding which health plans meet basic health insurance exchange quality standards by default.
The NCQA, Washington, and URAC, Washington, should get the exchange plan accreditation job because it looks as if they can handle the job, according to the U.S. Department of Health and Human Services (HHS).
HHS officials talk about accrediting plan accreditors in the preamble to a proposed rule that deals with Patient Protection and Affordable Care Act (PPACA) implementation issues.
Opponents of PPACA are fighting implementation of the law in Congress and in the courts.
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If PPACA is implemented as written and works as drafters expect, it will set up a new system of health insurance exchanges, or Web-based health insurance supermarkets. One PPACA provision, PPACA Section 1311(c)(I)(D)(i), requires that a “qualified health plan” (QHP) that sells coverage through a PPACA exchange be “accredited with respect to local performance on clinical quality measures,” HHS officials say in the proposed rule preamble, citing the text of PPACA.
“At this time,HHS has determined that recognizing entities through an interim phase one process is necessary to meet the timeline for exchange QHP certification activities, which commence in early 2013 and may include the accreditation requirement, depending on the timeline established by an exchange,” HHS officials say.
Eventually, the officials say, HHS wants to set up a formal application process and public notice approach for would-be accrediting entities, officials say.