Recently, Adena Health in Chillicothe, Ohio was denied accreditation by the National Committee for Quality Assurance (NCQA) in credentialing. This makes it one of only three hospitals in the country to have been denied this type of credentialing according to NCQA’s website. Accreditation is awarded to organizations that meet or exceed specific standards, while a denial indicates that the organization did not meet these requirements.
In order to achieve accreditation, organizations must comply with a set of requirements that include best practices and the delivery of high-quality care. NCQA evaluates clinicians and practices that use teamwork and technology to provide coordinated and patient-centered primary care through their credentialing program. Despite being denied accreditation, Adena Health maintains that their credentialing standards remain confident and has appealed NCQA’s decision.
Prior to this recent setback, Adena Health has been the subject of previous reports and lawsuits, including allegations of knowingly submitting false and fraudulent claims for payment to Medicaid and other government reimbursement programs. Additionally, there have been allegations that some of Adena’s cardiologists performed heart valve procedures without the proper credentials in 2022, which Adena has denied. Despite facing scrutiny and legal challenges, Adena Health remains committed to meeting changing requirements and ensuring high standards of care.