NOTICE - Use of National Accrediting Entities under the Health Care Professional Credentialing Act and the Quality Assessment and Improvement Act

To: All Companies Writing Health Insurance in Nebraska and Nationally Recognized Private Accrediting Entities

Under the Health Care Professional Credentialing Verification Act, specifically Neb.Rev.Stat. §§44-7001 et seq., and the Quality Assessment and Improvement Act, specifically, Neb.Rev.Stat. §44-7201 et seq. (“the Acts”), the Director of Insurance has the authority to recognize accreditation by one or more nationally recognized private accrediting entities, with established and maintained standards, as evidence of meeting some or all of the requirements of the Acts.

The Nebraska Department of Insurance (“Department”) has determined that an accreditation entity with standards that meet or exceed the requirements of the Acts, may request permission and authority from the Department to execute this function.

A health carrier that has achieved the national accreditation entity approved standards shall file the accreditation certificate and summary report with the Department, and shall be recognized by the Department as having met the requirements of the Acts. The Department retains full authority to enforce the provisions of Neb.Rev.Stat. §§44-7001 to 44-7013 and Neb.Rev.Stat. §§44-7201 to 44-7215 through the complaint process, market conduct, and other enforcement tools available to the Department.

Questions concerning this notice may be directed to Martin Swanson, Health Policy Counsel, at martin.swanson@nebraska.gov.