CMS Renews NCQA's Power to Certify Medicare Plans
Published Date: 7/27/2026
Notice
Summary
CMS has renewed the National Committee for Quality Assurance's (NCQA) power to approve Medicare Advantage Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) for six more years, from May 18, 2026, to May 18, 2032. This means NCQA can keep checking that these plans meet Medicare’s rules, helping keep care quality high for Medicare members. If you’re part of an HMO or PPO in Medicare Advantage, this keeps things running smoothly without extra costs or delays.
Analyzed Economic Effects
2 provisions identified: 1 benefits, 1 costs, 0 mixed.
NCQA Deeming Authority Renewed Six Years
CMS approved the National Committee for Quality Assurance (NCQA) to continue as a Medicare Advantage accrediting organization for Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) from May 18, 2026 through May 18, 2032. NCQA can continue to give accredited MA HMOs and PPOs “deemed” status showing they meet Medicare requirements in five areas: Quality Improvement; Anti-Discrimination; Confidentiality and Accuracy of Enrollee Records; Information on Advance Directives; and Provider Participation Rules. This renewal lets NCQA keep checking those plans so care quality is monitored and accredited plans may remain recognized as meeting Medicare rules.
Access and Part D Reviews Not Deemable
CMS does not accept accreditation as part of the MA deeming program for Access to Services (see Sec. 422.156(b)(3)) or for the Part D areas of review (see Sec. 423.165(b)). That means NCQA accreditation will not give MA plans deemed status for those two areas under the MA deeming program during the approval term.
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