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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). The company is currently certified in all 11 verification elements effective through April 15, 2020.
- 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 Accredited until January 22, 2020.
- 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 MHS Inc. d/b/a Magellan Complete Care has been awarded an Accredited status effective through February 4, 2022.
- Senior Whole Health, LLC, has a Commendable status for its Medicare line of business and an Accredited status for its Medicaid line of business. Health Plan Accreditation is effective through February 16, 2020.
- Magellan Complete Care of Virginia, LLC has an Interim Accreditation under Health Plan Standards effective through June 26, 2020.
Magellan’s three-year, Full NCQA MBHO Accredited sites include:
- Human Affairs International of California, Inc. (San Diego, California), effective through December 4, 2021.
- Magellan Healthcare, Inc. (Maryland Heights, Missouri), effective through June 29, 2019.
- Magellan Behavioral Health of Pennsylvania (Newtown, PA), effective through February 16, 2020.
Founded in 1990, URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. URAC is a nonprofit organization using evidence-based measures and developing standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. URAC’s portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability. Magellan has had sites accredited by URAC since 1992. In 2019, URAC awarded Magellan Healthcare Full Re-Accreditation under the Health Utilization Management Standards (v 7.3) for our behavioral health utilization management program.
- In 2019, Magellan Healthcare’s two units earned full URAC Re-Accreditation through June 1, 2022, under the Health Utilization Management Standards, version 7.3.
- Human Affairs International of California also earned Full Re-Accreditation through June 1, 2022, under the Health Utilization Management Standards, version 7.3.
- NIA has Full Health UM Accreditation under Health Utilization Management Standards, version 7.4 until December 1, 2022.
- Magellan RX Pharmacy has Full Accreditation under the Specialty Pharmacy Standards, version 2.0 until August 1, 2020, and Full Accreditation under the Health Utilization Management Standards, version 7.3 until September 1, 2020.
- Magellan Pharmacy Solutions/Magellan Rx Management has Full Accreditation under the Pharmacy Benefit Management Standards, version 2.2 through March 1, 2020.