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National Committee For Quality Assurance

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National Committee For Quality Assurance Reviews (1)

Thank you for the opportunity to respond to the complaint dated July 26, regarding NCQA's Patient-Centered Medical Home Content Expert CertificationTM Program.The National Committee for Quality Assurance (NCQA) is a private, 501(c)(3) not-for-profit organization dedicated to improving health
care qualityNCQA's Patient-Centered Medical Home (***) Recognition Program is a private market driven program that recognizes physician practices that demonstrate that they have successfully transformed the way care is delivered so that it is patientcentered and coordinatedWith more than 12,recognized physician practices (representing more than 61,clinicians) across the country, NCQA's *** Recognition Program, is the most sought after and widely accepted *** program in the nationBecoming NCQA Recognized requires strategies and efforts to transform a practice into a medical homeNCQA's Patient-Centered Medical Home Content Expert Certification'M (***) Program is designed to identify professionals with in-depth knowledge and experience in practice transformation and a comprehensive knowledge of NCQA's *** Recognition ProgramProfessionals who achieve the *** Content Expert Certification credential are able to highlight their comprehensive knowledge of the standards and guidelines, application process, survey process and documentation requirements of the NCQA *** Recognition Program.Individuals interested in receiving a professional designation from NCQA as a *** Certified Content ExpertTM must be years of age or older and successfully complete two rigorous *** education seminars and pass a comprehensive examinationCurrently NCQA has recognized *** Content Certified Experts who have successfully passed the examinationInterested candidates can learn more about the program and the examination in the NCOA Patient-Centered Medical Home (***) Content Expert Certification (CEC) Handbook.The Handbook provides detailed information about eligibility and scheduling of the examinationIn the Handbook candidates are informed that they are eligible for the current examination for up to one year from completion of the education seminarsIndividuals who do not pass the examination on the first attempt may retake the exam each quarter during their one year eligibility period until they pass but they must pay a fee of $The one-year eligibility period is repeated in several parts of the Handbook, including in the following excerpts:When applying for *** ***, candidates must attest that they are at least years of age and must complete the NCQA education requirementsAll candidates must complete:introduction to *** 2014: Foundational Concepts of the Medical Home (1.5-day seminar or 1-dayNCQA-led corporate training), andAdvanced *** 2014: Mastering the Medical Home Transformation (1-day seminar)NCQA lists the dates and times of all education seminars on its Web site at http:W.ncga.org/Education.After completing the seminars, candidates are identified as eligible for certification, and are assigned a unique nine-digit identification numberCandidates' names and information are submitted to the examination administration vendor, ***, and are entered into the *** system*** alerts candidates by e-mail and postcard when they are eligible to register for and schedule their CEC examinationThe e-mail and postcard will include the assigned nine-digit identification numberCandidates remain eligible for the current examination for up to one year from completion of the seminarsNCQA reserves the right to retire an examination, which may reduce a candidate's eligibility periodUpon expiration of the candidate's eligibility period, or upon retiring of an examination, candidates may be required to complete additional NCQA education seminars for certification eligibility.Testing WindowsThe *** *** Examination is offered during 10-day windows in March, June, September and DecemberThe examination is not offered during some holidaysPlease refer to the examination calendar on the *** *** Web page listed in Appendix 3.Retiring ExaminationsNCQA reserves the right to retire an examination when NCQA releases updates to the *** Recognition ProgramA candidate's eligibility period may be reduced when an examination is retiredNCQA provides notice to candidates of a retiring examination to the email provided with their application and by posting notice on NCOA's Web site as described in Section 5: Revisions to Policies and Procedures,Scheduling an examinationCandidates have one year from the date of eligibility to schedule and take the examinationExamination appointments are limited and are scheduled on a first-come, first-served basis, Candidates are encouraged to schedule an examination as soon as possible to guarantee an appointment prior to the end of the eligibility periodThere are two Ways to schedule an examination.In the complaint, a *** customer commented on the scheduling of her examination and the testing fees for subsequent retake attemptsNCQA reviewed the customer's records and confirmed the following informationThe customer completed her mandatory education classes as of April 20, 2016, making her eligible for the examination for one year through the March testing windowThe customer took the examination on September 21, 2016, and on December 19, The customer failed to achieve a passing score on either examination, although she is inaccurate in stating that she failed by one pointThe examination uses a scaled scoring methodology, known as the Angoff method that is described to candidates in the HandbookThe scaled scores are not the same as a percentage score and in both examinations the customer failed to achieve the minimum scaled score.Although not mentioned in the complaint, NCQA received an inquiry from the customer on March 13, requesting information related to retaking the examination, and NCQA responded on March 14,*** *** *** August 1, Page Even though the customer was only eligible to retake the examination through the March testing window, NCQA informed the customer that it would be announcing an additional testing window in August and would allow the customer to sit for the examination in August despite the expiration of her one-year eligibility periodNCQA announced the opening of the August testing window to all candidates by email dated July 7, This additional testing window was opened by NCQA to permit candidates that previously failed the exam one more opportunity to retake the exam before this version of the test is retired.NCQA does not have a record of inquiries from the customer on June or July 1, 2017, but did receive an inquiry on July 10, 2017, and NCQA responded by email on July 11, 2017, and included the name and phone number of senior staff member to assist her with any additional questionsThe customer was again informed that NCQA would allow her to retake the examination during the August testing window despite the expiration of her eligibility periodNCQA confirmed that the customer scheduled to retake the examination on August 14, While the customer has stated in her complaint that she is now unavailable to retake the examination in August, NCQA cannot open a new testing window for individual applicantsThe *** *** Examination for NCQA's *** Recognition Program is retired as of the end of the August testing window and is replaced in all future testing with a new *** *** Examination on NCQA's *** Recognition Program, Edition.The scheduling of the examination, including the choice of location, is coordinated by the customer with *** *** *** (***), NCQA's vendor to administer the examinationThe customer may reschedule their examination once at no additional charge by calling *** at least two days before the examination dateBecause the customer has already scheduled her examination for August 14, 2017, NCQA recommends that the customer contact *** to discuss a change in the location of the testing center or an alternative date in the August testing window.While we regret that the complainant has not successfully achieved *** Content Expert Certification to date, we believe that our testing process is important to ensuring that professionals who receive certification and represent NCQA's brand are highly knowledgeable in the field and will be able to assist practices in preparing to achieve NCQA *** RecognitionNCQA will respond directly back to the customer with the information to contact *** regarding her scheduled appointment and available *** testing locations.Please let me know if you need any additional information regarding this matter.Thank you, Donna M*** Deputy General Counsel

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