Updated Contract Language Required for NCQA Health Plan Accreditation

Date: 08/13/18

California Health & Wellness Plan (CHWP) is subject to various statutory, regulatory and accreditation requirements, and must ensure that all agreements comply with any such mandates. Accreditation from the National Committee for Quality Assurance (NCQA) is critical to both the health plan and network providers, and ensures that CHWP meets the highest possible standards of excellence and care.

One of the requirements of NCQA is that CHWP may use practitioner performance data for quality improvement activities. Therefore, CHWP’s contract templates have been updated with the following language:

Provider agrees to cooperate with quality management and improvement (QI) activities; maintain the confidentiality of member information and records pursuant to this agreement; and allow  California Health & Wellness Plan to use provider’s performance data.

Thank you for your continued support of the highest standards of quality care for CHWP members.

ADDITIONAL INFORMATION

Relevant sections of CHWP’s provider operations manual have been revised to reflect the information contained in this update as applicable. The provider operations manual is available in the Provider Resources section of the www.CAHealthWellness.com website.

Providers who have questions or need additional information may contact CHWP Provider Relations at 1-877-658-0305.