Which organization is described as a private, not-for-profit entity identified by HHS as the accrediting body for Qualified Health Plans?

• A. NCQA
• B. JCAHO
• C. CMS
• D. AHA

Answer: (A)

Understanding who accredits Qualified Health Plans centers on recognizing that HHS designates a private, nonprofit organization to set and assess quality standards for health plans offered in the Marketplace. The National Committee for Quality Assurance fits this role: it’s a private, nonprofit entity that develops criteria for health plan quality and accredits plans that meet those standards, and HHS identifies NCQA as the accrediting body for QHPs. Other groups fit different functions: The Joint Commission accredits hospitals and other facilities, not QHPs; CMS is the federal agency that runs Medicare/Medicaid and Marketplace administration, not the accrediting body for QHPs; and the American Hospital Association is a professional association, not an accreditor of health plans.