Updated NYS PCMH Standards and Guidelines Now Available

Tuesday, July 31, 2018 9:50 AM | Anonymous

NCQA updates the NYS PCMH publication annually to clarify guidance and refine criteria expectations. Download the NYS PCMH Standards and Guidelines (2017 Edition, Version 3) to review.

Highlights of the update include:

  • Organizations with two or more sites are now allowed to share or partially share an additional 21 criteria across practice sites, saving time and reducing documentation.
  • Updates to guidance language for clarity of criteria.
  • Updated selected concept and competency descriptions to align with criteria included in the concepts and competencies.

Summary of Changes to PCMH Standards and Guidelines

Practices may share evidence for these criteria:

KM 02-KM 05

AC 05

CC 01

CC 02

CC 04

CC 10

CC 14-CC 16

CC 18

CC 19

QI 15

QI 16

BH 02





CM 04-CM 08

Practices may share examples for CM 04-CM 08, although each site must still provide a Record Review Workbook.

QI 06

Practices must provide site-specific evidence for QI 06.

TC 01, TC 04

Clarified requirements for these criteria.

TC 03

Removed the reference to health information exchanges (HIE).

Updated guidance to clarify that participating in an ACO or clinically integrated network does not meet this criterion.

TC 09

Clarified the criterion language to require practices to periodically remind patients of the roles and responsibilities of the medical home.

CM 05

Clarified criterion language to require practices to give written care plans to patients electronically or as a printed document.

CC 09/BH 05

Removed text: "The practice must provide a report, log or electronic tracking system as evidence of implementation."

CC 14

Updated evidence from "Report" to "Evidence of implementation."

CC 16

Evidence updated from "Evidence of follow-up" to "Evidence of implementation." 

CC 18-CC 19

Removed the requirement for practices to provide at least three examples of data exchange (CC 18) and obtaining discharge summaries (CC 19).

QI 07

Clarified the criteria's language and guidance to further differentiate between QI 05 and QI 07.

QI 10

Clarified the criterion language to state that practices that have met their appointment availability access goals may focus on improvement in another patient-access area.

QI 15-QI 16

Modified criteria language to clarify that practices may report clinician-level data or practice-level data.

Summary of Changes to NYS PCMH Policies and Procedures

  • Rearranged and updated portions of the Overview section for clarity.
  • Updated the Commit, Transform and Succeed sections to align with changes to the Q-PASS process.
  • Added a section describing the role of the prevalidated vendor and NCQA investigation.
  • Expanded the Reportable Events Policy to clarify when and how to inform NCQA of reportable events such as mergers, acquisitions, consolidations and investigations.

Thank you for your ongoing commitment to delivering high-quality, patient-centered care. If you have questions, submit them through My NCQA.

Powered by Wild Apricot Membership Software