Medicaid Managed Care - U.S. Senate Special Committee on Aging

781
Protecting Consumer Rights in Public Systems'
MANAGED MENTAL
HEALTH CARE POLICY
A Series of Issue Papers on Contracting for <strong>Managed</strong> Behavioral Health <strong>Care</strong>
#2
NCQA
ACCREDITATION
STANDARDS:
Insufficient
Quality Check
Unless
Supplemented for
Public-Sector
Systems.
The National <strong>Committee</strong> for Quality Assurance-ONCQA) recently
released standards for accreditation of managed behavioral healthcare organizations.
NCQA has previously provided accreditation for managed
bealts care plans (such as health maintenance organizations); the new
standards will result in NCQA's accrediting managed behavioral health
care plans as well, such as those now contracting with states to manage
public mental health and addiction treatment systems.
The new NCQA behavioral health care standards are not specifically
designed for public-sector managed care. The Bazelon Center for
Mental Health Law considers them to be insufficient as a quality control
for mental health and addiction services funded by <strong>Medicaid</strong> or
mental health, substance abuse or other public agencies. The standards
may be more appropriate for use by plans contracting with a business
for an acute-care behavioral health benefit for its employees.
To ensure appropriate quality and performance standards in publicsector
contracts with managed behavioral health care entities, public
purchasers (states or local governments) should address various issues
more comprehensively than does NCQA. In this analysis, the Bazelon
Center identifies areas in which public purchasers should expand their
standards for managed care entities beyond the NCQA minimum.
OVERVIEW OF STANDARDS
The purpose of establishing accreditation standards is to set a minimum
level of quality control over health care providers or managed
Ecarrntities. In addition to NCQA, other entities (such as the Joint
Commission on the Accreditation of Healthcare Organizations) issue
proposed standards or accredit mental health agencies. By providing this
A POLICY ANALYSIS SERIES FROM THE BAZELON CENTER FOR MENTAL HEALTH LAW
1101 I5dsSo-NW. 1212. WignDC2C05 a202/467.5730 *TDD4674233,fa202/223-0409 *1HN16600fhard .- b.oo