What is a Reportable Event according to NCQA policy?

A Reportable Event according to NCQA policy refers specifically to significant occurrences that could affect the organization's compliance, safety, or quality of care. This includes a final determination of sanctions by a regulatory body. Such events are critical for the accountability and operational integrity of healthcare practices, as they may result from serious infractions or non-compliance with established standards. Reporting these events is essential because it allows for transparency and facilitates appropriate response mechanisms to maintain quality and safety in healthcare delivery.

In contrast, routine audits, changes in staffing without significant impact, and minor adjustments in service hours do not typically reach the threshold of significance outlined by NCQA for a Reportable Event. These occurrences, while relevant to operational processes, do not likely compromise compliance or the quality of care to the same degree as sanctions from a regulatory body. Therefore, they do not need to be reported in the same manner as significant regulatory actions.