NCQA Health Plan / CVO Credentialing standards CR 1 (Credentialing Policies) and CR 3 (Credentialing Verification), current edition
NCQA credentialing: sanctions and exclusion verification time frames
NCQA requires verification of sanctions, restrictions on licensure and Medicare/Medicaid sanctions from an acceptable primary or recognized source, within the verification time frame before the credentialing decision, and recredentialing at least every 36 months. source
Who it reaches
Health plans, CVOs and delegated credentialing entities; hospitals that follow NCQA for allied health and telemedicine.
The record the rule expects
The LEIE and state Medicaid list reads by NPI and exact name, the state license board rows with expiry as printed, the read date and the source's own date — kept in the credentials file as the primary-source verification of sanctions.
Free
Read one name now — every source, dated, hashed.
Free, once
500 names you already screened — the 48-hour comparison.
Sector receipt
/receipts/for/hospitals
Duty Sheet
One page per rule, generated on any receipt
Protocol template
Adopt it as yours; set every threshold
Questions readers ask
Is this platform an NCQA 'acceptable source'?
The acceptable source is the agency file itself (LEIE, state list). The receipt is a dated read of that source; it is a record, not a secondary database.
What is printed when a source did not answer?
'Did not answer', with the time. The file notes which source was not verified and the committee decides under its bylaws.
This page quotes the rule and describes the record; whether your organization meets the rule is your compliance office's and counsel's reading. All rules · Methodology.