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.
Your PRIA Score
Personalized for You
How does this regulation affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this federal register document and every other regulation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Key Dates
Department and Agencies
Related Federal Register Documents
2026-04797 — Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction
This document fixes some typos and technical mistakes in the Medicare and Medicaid payment rules for 2026. It affects doctors, healthcare providers, and anyone using Medicare Part B by clarifying payment policies and program requirements starting January 1, 2026. These corrections help make sure payments and coverage rules are clear and accurate, so everyone gets paid right and on time.
2026-04467 — Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction
This correction fixes some missing labels in important tables from the 2027 health insurance rules under the Affordable Care Act. It mainly affects insurance companies and people using marketplace plans by clarifying how risk and payments are calculated. These fixes take effect right away on March 6, 2026, ensuring everyone has clear info before the 2027 plan year starts.
2025-23081 — Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program; Correction
This correction fixes some math and typo mistakes in the Medicare payment rules for inpatient rehab facilities starting October 1, 2025. It mainly affects rehab centers by updating their payment rates and quality reporting details to be fair and accurate. These changes ensure providers get the right money and info for the 2026 fiscal year.
2025-22543 — Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model
Medicare is updating its payment plans to help more people get organ transplants through the Increasing Organ Transplant Access (IOTA) Model starting in Performance Year 2. These changes affect hospitals and doctors who work with Medicare patients needing transplants, aiming to improve care and save lives. Comments on the proposed rule are open until February 9, 2026, so stakeholders can share their thoughts before it’s finalized.
2025-21767 — Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies
Starting in 2026, Medicare is updating how it pays for home health care and durable medical equipment, making sure payments match patient needs better. Home health providers will see new rules for quality reporting and value-based programs, while suppliers must meet updated accreditation and enrollment standards. These changes affect patients, providers, and suppliers, with payment updates and new deadlines kicking in early next year.
2025-21458 — Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program; Correction
This document fixes some technical mistakes in the Medicare payment rules for 2026, especially about payments for skin substitutes. It affects doctors, Medicare patients, and providers by clarifying how certain payments work starting November 28, 2025. No big changes in money, just important corrections to keep things running smoothly.
Previous / Next Documents
Previous: 2026-04601 — Sunshine Act Meetings
The Nuclear Regulatory Commission (NRC) is keeping things transparent by sharing its public meeting schedule for March and April 2026 — but guess what? No meetings are planned during these weeks! If you want updates or special accommodations, the NRC’s got you covered with easy ways to stay in the loop and join in.
Next: 2026-04594 — Submission for Office of Management and Budget Review; Title Central Authority Payment Service (New Collection)
The Office of Child Support Enforcement is launching a new Central Authority Payment Service (CAP) to help states and foreign agencies send and receive child support payments electronically and securely. This new system will make international payments faster and easier by bundling payments and converting currencies automatically. States and foreign authorities need to sign up to join, and public comments are open until April 9, 2026.
Take It Personal
Get Your Personalized Policy View
Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.
Already have an account? Sign in