About this Learning Activity

Health Plan Accreditation with SY 2026 Updates Series

NCQA Health Plan Accreditation is the only program in the industry that bases results on clinical performance and consumer experience (HEDIS® and CAHPS®). These courses will focus on taking a deep dive into all the relevant updates for the newly released standards. Our experienced presenters will provide learners with insight to interpret the requirements, navigate the standards, and avoid misconceptions. In addition to answering questions, presenters address generalized scenarios and provide examples based on performance improvement opportunities from prior NCQA surveys.

Organizations that acquire the 2026 Health Plan Accreditation Survey Readiness Package must purchase additional registrations for learners exceeding the two (2) learner limit offered through the package. The NCQA publication related to this training may be accessed, here: https://store.ncqa.org/health-plans-other-organizations/health-plans-hp.html 

Who Should Attend

Clinicians, executives, managers, specialists, consultants, delegates, and vendors who are employed or contracted by health plans with responsibilities related to case management operations, including:

• Accreditation or Compliance
• Case Management
• Social Work
• Population Health
• Quality Assurance
• Utilization Management

What You Will Learn

Content Topics

• Credentialing (CR)
• Delegation
• Member Experience (ME)
• Network Management (NET)
• Population Health Management (PHM)
• Quality Management & Improvement (QI)
• Utilization Management (UM)
  

Learning Objectives

Throughout this course, learners will: 

• Describe the updates and changes to the standards and requirements, and their implications.
• Interpret the intent of requirements for health plan accreditation.
• Describe relationships and themes across the standards.
• Recognize requirement implications and considerations for stakeholders.
• Define performance improvement opportunities.

Learning Outcomes

After completing this course, learners will be able to:

• Conduct a gap analysis regarding organizational performance against standards.
• Prioritize initiatives and action items for improving performance.
• Manage internal and external stakeholder expectations for service delivery.       

Learning Materials and Resources

• Presentation slides.
• Recording of live session.
• Scenarios for applied learning.
• NCQA surveyor's perspective of the standards.

Faculty

Clint Koenig, MD | NCQA Physician Surveyor

Clint Koenig, MD, MA, MSPH is the Senior Medical Director at OhioHealthy, a new system-based health plan in Columbus, Ohio. He has served as State Medical Director in New Hampshire and Ohio. Other leadership roles include the Health Plan Regional Chief Medical Officer at Universal American, a government programs health management organization in Syracuse, New York, as well as, the Director for Utilization Management at Monroe Plan for Medical Care, a healthcare management organization in Rochester, New York. In addition, Clint held Chief Medical Officer roles in Federally Qualified Health Centers and integrated delivery systems. He has been an NCQA surveyor for 10 years and surveys health plans, Patient Centered Medical Home, Special Needs Plans and Long Term Services and Supports organizations. Dr. Koenig received his MD from Albany Medical College in Albany, New York. He completed his residency in Family Medicine, from the University of Missouri. He also completed a fellowship at the University of Missouri, where he received a master’s degree in Public Health and Journalism.

Joseph Stankaitis, MD | NCQA Physician Surveyor

Dr. Stankaitis is a lecturer and Executive-In-Residence at the Cornell University Sloan Program in Health Administration. Joe is the longest serving physician surveyor for NCQA being involved since its inception as a surveyor and serving as Chair of its Reconsideration Committee (two separate terms) and Chair of the Review Oversight Committee. Clinically he has served as a member of the American Diabetes Association’s (ADA’s) Professional Practice Committee, President of the Volunteer Board of the Upstate NY ADA and currently is a member of the ADA’s national Health Disparities Committee. He additionally has participated on numerous New York State Department of Health Committees and Work groups. Joe received his B.A. in Biology from Boston College, his MD from the University of Connecticut School of Medicine, MPH in Health Policy and Management as a Kellogg Fellow at the Harvard School of Public Health, and completed his Residency and Chief Residency training in the Primary Care Program in Internal Medicine at the University of Rochester School of Medicine and Dentistry.

Irv Koehler, RN | NCQA Nurse Surveyor
Irv Koehler is a health care quality consultant for the Koehler Quality Group, LLC. In this position, he is an NCQA administrative surveyor and provides consulting services to organizations evaluating and preparing for NCQA Accreditation/ Certification projects, risk adjustment validation for managed care organizations, education on quality improvement practices and outcome measure development and tracking. Mr. Koehler is also a registered nurse with active licensure in Florida and Tennessee, and certification in quality and medical coding. Previously, he was a quality improvement professional at AmeriHealth Caritas and BlueCross BlueShield of Tennessee.
Mr. Koehler has an MBA from the Florida Institute of Technology, a BS in Nursing from Florida Southern College, a BA in Psychology and an ADN from Purdue University.

Continuing Education

These courses grant 1.0 Continuing Education Unit (CEU) points, each,  for PCMH Certified Content Experts.

This is a non AMA PRA Category 1 Credit^TM, ANA CNE, ACPE activity.

* Please note – You must attend the entire program to be eligible for total number of contact hours.

Disclosure of Relevant Financial Relationships

The National Committee for Quality Assurance (NCQA) endorses the Standards of the Accreditation Council for Continuing Medical Education which specify that sponsors of continuing medical education activities and presenters at and planners for these activities disclose any relevant financial relationships either party might have with commercial companies whose products or services are discussed in educational presentations.

For sponsors, relevant financial relationships include large research grants, institutional agreements for joint initiatives, substantial gifts, or other relationships that benefit the institution.  For presenters or planning committee members, relevant financial relationships include the receipt of research grants from a commercial company, consultancies, honoraria, travel, or other benefits, or having a self-managed equity interest in a company; or having an immediate family member or partner with such a relationship.

Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

Relevant financial relationships exist with the following companies/organizations:

Faculty:

Clint Koenig, MD

Irv Koehler, RN

Joseph Stankaitis, MD

Gerald Stewart

Additional Planning Committee Members:
Vince Pereira: None

Felicia Khaalid: None

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).