Updated PCMH Standards and Guidelines

(excerpted from NCQA newsletter)
NCQA updates the PCMH Standards & Guidelines publication periodically to clarify guidance, revise resources and refine criteria expectations. The latest update was released on January 29, 2019.

PCMH 2017 Edition, Version 4, is available for download via NCQA's Download Center. Log in using your email address and password. You can also find them on the FQHC.org website home page under “FQHC Resources.”

Summary of Changes to PCMH Standards and Guidelines

  • Updated Fee Schedule information to include other fees that may be incurred. 

  • Clarified expectations for practices that don't complete the Recognition process within 12 months or 3 check-ins.

  • Added guidance on purchasing and using an additional check-in.

  • Clarified the Audit and NCQA Investigation process: Clinicians on the Review Oversight Committee make the final revocation decision.

  • Updated Reporting Results to state that information collected during evaluations may be used for NCQA education and research.

  • Retired and added new measures to the Quality Measures Crosswalk (Appendix 5).

  • PCMH Distinction in Patient Experience Reporting will be retired after the April 2019 submission period (refer to Appendix 6).

  • Replaced "Report" with "Evidence of Implementation" in Required Evidence (CM 03).

Updates go into effect for all enrolled and recognized practices on March 1. Refer to the Policies and Procedures in the PCMH Standards & Guidelines for details.

Thank you for your ongoing commitment to delivering high-quality, patient-centered care. If you have questions, submit them through My NCQA.

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