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Official Website

of the Commonwealth of Pennsylvania

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    General Publications

    NCQA or URAC Certifications

    As per CFR 438.332, the department posts the certificate of accreditation by a Private Independent Entity. The posted certificates reflect the following agencies: the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC).

    External Quality Review Projects

    The Balanced Budget Act (BBA) of 1997 requires that state agencies contract with an External Quality Review Organization to conduct an annual external quality review of the services provided by contracted Medicaid Managed Care Organizations.