NCQA's Medicare Plan Checks Get Renewal Nod from CMS
Published Date: 3/10/2026
Notice
Summary
CMS is thinking about renewing the National Committee for Quality Assurance’s (NCQA) special approval to check Medicare Advantage health plans like HMOs and PPOs. This means NCQA can keep making sure these plans meet Medicare’s rules, helping millions of people get good care. If you want to share your thoughts, you’ve got until April 9, 2026, to speak up!
Analyzed Economic Effects
2 provisions identified: 1 benefits, 1 costs, 0 mixed.
NCQA May Keep Deeming Medicare Advantage Plans
CMS is considering renewing the National Committee for Quality Assurance's (NCQA) authority to 'deem' Medicare Advantage HMOs and PPOs. NCQA submitted its renewal application on December 19, 2025, and its prior approval ran from December 30, 2020 to December 30, 2026. If approved, NCQA could continue granting 'deemed' status for the following areas: Quality Improvement; Anti-Discrimination; Confidentiality and Accuracy of Enrollee Records; Information on Advance Directives; and Provider Participation Rules.
Some Areas Not Eligible for Deeming
CMS states it does not recognize accreditation for Access to Services (see 42 CFR 422.156(b)(3)) or the Part D areas of review (see 42 CFR 423.165(b)) as part of the Medicare Advantage deeming program. That means accreditation by a CMS-approved organization would not provide 'deemed' status for those two areas.
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