Cigna has earned accreditation and certification from The National Committee for Quality Assurance (NCQA) and URAC in acknowledgement of our longstanding history and strong commitment to quality in health care services. The nationally-recognized accreditations by NCQA and URAC affirms Cigna’s mission statement to improve the health and well-being of the individuals we serve through an integrated approach to quality and affordability in health care. This mission and approach is a common value shared across several organizations and programs within Cigna.

About URAC

URAC is an independent, non-profit organization that promotes health care quality through its accreditation, education and measurement programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, please visit www.urac.org.

Cigna’s dedication to the delivery of quality services is demonstrated by the continuous improvement of business processes through benchmarking against nationally recognized standards. Cigna has received several URAC accreditations:

URAC Accreditation:

URAC Case Management

URAC Case Management

By achieving URAC Accreditation, Cigna's case management program displays leadership through a commitment to quality and accountability. People coping with a wide range of health challenges, such as cancer, a transplant or a complicated pregnancy, benefit from the caring support provided to them by Cigna case managers. URAC accreditation ensures the delivery of quality services to our customers in managing transitions of care to reduce readmissions, improve and maintain their health. To verify Cigna's Case Management accreditation, please visit URAC.org.

URAC Health Utilization Management

URAC Health Utilization Management

URAC accreditation provides a mark of distinction for organizations demonstrating their commitment to quality health care. Through Cigna's Health Utilization Management Accreditation, URAC affirms Cigna's use of evidence-based guidelines and specific review requirements that meet the demands of a changing health care system. Cigna's utilization management program is supported by reliable policies and procedures used during the review of health care services for medical necessity and appropriateness of care to help ensure easy access to care and correct administration of our customer’s benefits. To verify Cigna's Utilization Management accreditation, please visit URAC.org.

URAC Pharmacy Benefit Management

URAC Pharmacy Benefit Management

Quality health care is crucial to our customers and it is important to Cigna to be measured against national standards and undergo rigorous evaluation by an independent accrediting body, which validate our commitment to quality. Cigna’s pharmacy benefit management ensures that contract terms and pricing are clear, so that individuals have access to the drugs and pharmacies they need to be healthy. To verify Cigna's Pharmacy Benefit Management accreditation, please visit URAC.org.

URAC Specialty Pharmacy

URAC Specialty Pharmacy

Cigna's attainment of URAC Specialty Pharmacy Accreditation provides an external validation of excellence in Specialty Pharmacy Management and demonstrates Cigna's orientation to continuous quality improvement. Customers receiving drugs that may require special handling or administration due to chronic diseases or complex therapies are provided support through comprehensive patient education services and coordination with the patient and the prescriber of the drug. Cigna's URAC Specialty Pharmacy Accreditation is valuable to our customers due to its focus on quality standards and educational support. To verify Cigna's Specialty Pharmacy accreditation, please visit URAC.org.

About the National Committee for Quality Assurance

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®1) is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information for consumers, purchasers, health care professionals and researchers. For more information, please visit NCQA.org.

The following NCQA Accreditations and Certification underscores Cigna's commitment to excellence, quality and affordable health care to the individuals we serve.

NCQA Accreditation:

NCQA Health Plan Accreditation

NCQA Health Plan Accreditation evaluates how well a health plan manages its entire delivery system, including physicians, hospitals and other facilities, as well as administrative services. Cigna implements and manages numerous activities throughout the organization to ensure processes and opportunities are objectively and systematically monitored, and evaluated, to improve the quality and appropriateness of care and services. This ongoing quality oversight support Cigna's success in earning NCQA Health Plan Accreditation. To view Cigna's Health Plan Accreditation Report Card, please visit NCQA Healthplan Report Card.

NCQA Managed Behavioral Health Organization

NCQA Managed Behavioral Health Organization

Cigna has earned full NCQA Managed Behavioral Healthcare Organization (MBHO) Accreditation for how well it manages its entire delivery system, including physicians, hospitals and other facilities, as well as administrative services. NCQA reviews include rigorous on-site and off-site evaluations conducted by a team of physicians and managed care experts. Earning Full Managed Behavioral Health Organization Accreditation from NCQA is a powerful validation of Cigna's ongoing commitment to quality and demonstrates dedication to helping our customers. To view Cigna's Management Behavioral Health Organization Accreditation Report Card, please visit NCQA MBHO Report Card.

NCQA Disease Management Accreditation

NCQA Disease Management Accreditation

Cigna's accredited Disease Management (DM) programs include asthma, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease, depression and diabetes. Earning NCQA Disease Management Accreditation is an indication that Cigna’s DM program is dedicated to giving patients and health care professionals the support, education and other help necessary to facilitate good outcomes and care. NCQA’s Disease Management Accreditation program is designed to help individuals evaluate Disease Management programs and to improve patient care and service. To view Cigna's Disease Management Accreditation, please visit NCQA Disease Management Report Card.

NCQA Wellness and Health Promotion Accreditation

NCQA Wellness and Health Promotion Accreditation

The NCQA Wellness & Health Promotion Accreditation – “Accredited With Performance Reporting” – is effective for three years. It applies to a wide range of Cigna's health and wellness programs, including:

To view Cigna's Wellness and Health Promotion Accreditation-Accredited With Performance Reporting Report Card, please visit NCQA Wellness and Health Promotion.

NCQA Physician and Hospital Quality Certification

NCQA Physician and Hospital Quality Certification

The NCQA Physician and Hospital Quality (PHQ) Certification program evaluates how well health plans measure, and report the quality and cost of physicians and hospitals. Cigna earned PHQ certification for two physician quality measurement programs: Physician Quality and Cost Efficiency Displays and Cigna Care Designation. Certification was also achieved for Cigna's hospital quality measurement program, Centers of Excellence. These Cigna programs provide our customers with information about quality and cost, which may help them make better, more informed decisions when choosing physicians and hospitals. To view Cigna's Physician and Hospital Quality Certification Report Card, please visit NCQA Physician and Hospital Quality.

NCQA Patient-Centered Connected Care™ Recognition Program

NCQA Patient-Centered Connected Care™ Recognition Program

The National Committee for Quality Assurance (NCQA) Patient-Centered Connected Care™ Recognition Program evaluates a number of factors, such as:

  • How health care sites connect with primary care and other health care providers
  • The type of patient care and support provided
  • Electronic system capabilities
  • Quality measurement

Health care delivery sites that demonstrate they follow certain protocols in these areas are positioned to earn a NCQA seal, reflecting their commitment to quality and a patient-centered approach to care delivery. Cigna has become one of the first companies to be recognized by the NCQA’s new Patient-Centered Connected Care (PCCC2) Recognition Program. This recognition applies to seven Cigna onsite health centers: two that serve employees of Cigna clients in Arlington, VA, and Council Bluffs, Iowa and five that serve Cigna employees in Hartford, CT, Chattanooga, TN, Philadelphia and Scranton, PA, and Plano, Texas. The recognition reflects Cigna's longstanding commitment to health care quality and health improvement by offering clinical programs and services that are assessed by external accrediting organizations such as the NCQA. To learn more about NCQA’s PCCC Recognition Program, please visit NCQA Patient Centered Connected Care.

 

1“HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).”
2“Patient-Centered Connected Care™ Recognition Program is a trademark for the National Committee for Quality Assurance (NCQA).”

Notice of Accreditation Survey (February 12, 2019)

The Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) will conduct an accreditation survey of the following organization, for whom Cigna provides medical and network management services, at each of their respective headquarters:

  • Special Agents Mutual Benefit Association (SAMBA) Health Benefit Plan - March 25-27, 2019

The survey will be used to evaluate compliance with the AAAHC standards for a health plan and to determine if accreditation should be awarded to, or retained by, the health plan.

Through an emphasis on education and consultation, the ultimate purpose of the accreditation process is to improve the quality of health care and member services.

The organizations listed above have voluntarily requested this survey as a means of assisting their own efforts to improve the quality of health care and member services. The health plan’s members, members of the general public, providers and staff members believing that they have pertinent and valid information about the above health plans’ compliance with AAAHC standards, may request an information presentation with AAAHC surveyors at the time of the survey for the purpose of presenting such information, or may communicate such information in writing or by telephone to the AAAHC. All pertinent information received from identified individuals at or before the survey will be considered in the accreditation decision process.

Requests for presentation must be received at least two weeks before the survey in order to allow sufficient time to schedule the presentations. Requests for public information presentations or reporting of pertinent and valid information may be communicated in writing or by telephone to AAAHC at the following address and telephone number:

Accreditation Association for Ambulatory Health Care, Inc.

Health Plan Services

5250 Old Orchard Road, Suite 200

Skokie, IL  60077

Telephone (847) 853-6060

FAX (847) 853-9028