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Industry accreditations

 

National Committee for Quality Assurance (NCQA)

NCQA is a national organization that accredits/certifies Managed Behavioral Health Organizations (MBHOs), Utilization Management Organizations (UM) and Health Plans (HP). Magellan is one of the leaders in the industry in NCQA accreditation and is uniquely positioned to work with Health Plan customers to take full advantage of new NCQA standards and guidelines.

  • Magellan was the first MBHO in the nation to earn certification as a Credentials Verification Organization (CVO). We have held certification as Magellan since 2006 (and prior to the Magellan name in 1999).
  • Annually, Magellan Health completes a corporate NCQA managed behavioral health organization corporate survey. NCQA reviews approximately 50 standards and elements related to centralized corporate functions.
  • NIA is NCQA Utilization Management Certified until February 8, 2018.
  • Magellan was instrumental in helping NCQA shape its MBHO accreditation program by providing NCQA with extensive feedback on draft standards and hosting pilot corporate and site reviews.
  • Florida MHC, Inc. (d,b,a. Magellan Complete Care)

Magellan's three-year, Full NCQA MBHO Accredited sites include:

  • Magellan Health Services of California / HAI of California Care Management Center (San Diego, California)
  • Clinical Center of Excellence Unit (Alpharetta, Georgia)
  • Employer Customer Center of Excellence (St. Louis, Missouri)
  • Magellan QIO, LLC, (d.b.a., Magellan of Virginia)

URAC

URAC, an independent, nonprofit organization, is well known as a leader in promoting health care quality through its accreditation and certification programs. In 2016, URAC awarded Magellan Full Re-Accreditation under the Health Utilization Management Standards (v 7.2) and the Case Management Standards (v 5.0) for our behavioral health utilization management and case management programs.

  • In 2016, five of Magellan's Units earned full URAC Re-Accreditation through June 1, 2019 under the Health Utilization Management Standards, version 7.2.
  • In 2014, Magellan of Louisiana was awarded Full Accreditation under Health Utilization Management Standards, version 7.0 through January 1, 2017.
  • Magellan was the first MBHO to be accredited under URAC's Case Management standards. Currently, the Clinical Center of Excellence in Alpharetta, Georgia has been awarded Case Management Accreditation through September 1, 2019, under the Case Management Standards, version 5.0.
  • Magellan has had sites accredited by URAC since 1992.
  • NIA has Full Health UM Accreditation under Health Utilization Management Standards, version 7.0 until December 1, 2016.
  • Magellan Rx Management/Magellan Pharmacy Solutions/Magellan RX Pharmacy has Full Accreditation under the Specialty Pharmacy Standards, version 2.0 until August 1, 2017, and Full Accreditation under the Health Utilization Management Standards, version 7.0 until September 1, 2017.
  • Magellan Pharmacy Solutions/Magellan Rx Management has also received Full Accreditation under the Pharmacy Benefit Management Standards, version 2.0 through March 1, 2017.