Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 482 - NEBRASKA MEDICAID MANAGED CARE
Chapter 6 - QUALITY
Section 482-6-006 - ACCREDITATION
Current through September 17, 2024
The Heritage Health plans must have National Committee for Quality Assurance Accreditation or another national accreditation for the Medicaid Managed Care plan. The dental plan must have National Committee for Quality Assurance Accreditation or URAC accreditation. The health plans must submit a copy of the accrediting body's letter indicating the most recent accreditation status at the time of initial contracting. The plans must submit any changes or updates to the Department within thirty (30) days of receipt.
006.01 SURVEY RESULTS. Upon survey by the accrediting body, the health plan must submit a copy of the survey results to the department within thirty (30) days of receipt. The health plan must submit a copy of any work plan that addresses improvements needed or follow-up necessary because of the survey. The plan must submit any changes or updates to the survey results or work plan to the Department within 30 days of receipt.
006.02 NON-ACCREDITATION. In the event that a health plan is not accredited at the time of contracting, the health plan is required to submit to the Department, for approval, a plan to be fully accredited within the five year contracting period. The health plan must submit a work plan including the timeline to accomplish plan accreditation to the Department. The health plan must provide a status update to Departmental staff at the time of the annual on-site operational review.
