# REGULATORY OVER 30 AGENCIES ® TRUST QUEST ANALYTICS

## Industry-Leading Network

## Adequacy and Provider Directory Accuracy Solutions

For nearly two decades, our solutions have been the gold standard for network adequacy and provider directory accuracy, championing compliance with key regulatory standards. Our long-standing relationships with the Centers for Medicare & Medicaid Services (CMS), the Consumer Information and Insurance Oversight (CCIIO), and over 30 state agencies like the Departments of Insurance and Health and Human Services, and independent review organizations, underscore the widespread trust and reliability vested in our provider network management solution.

## Trusted by Regulatory Agencies Nationwide

With our solution, you gain invaluable insights and tools, identical to those used by agencies regulating programs such as Medicare Advantage, Federal and State-based Exchanges, and Medicaid and CHIP. Our unique position in the industry offers an unmatched advantage, aligning your operations seamlessly with regulatory expectations and minimizing compliance hurdles.

## Innovation at the Forefront

Our commitment to innovation guarantees that you are prepared to address current and future regulatory demands. As regulatory bodies revise their criteria for evaluating network adequacy and as the requirements for provider data accuracy increase—including the need to demonstrate provider activity with claims data—we continuously update our solution and methodologies to help you effectively meet evolving compliance standards.

## Federal and State Templates

**Our solutions and services are designed to help you meet the changing requirements of both federal and state regulatory compliance.** At the core of Quest Enterprise Services® (QES®) is our industry-leading network adequacy capabilities. With our renowned Network Adequacy Templates, you receive the essential tools needed for ongoing assessment of your network against regulatory criteria.

**"CMS has the contract with Quest Analytics to do their own analysis and so does our state’s Department of Health. The tool they use to measure our adequacy is the same tool we use internally. That means we don’t run into any surprises. We know that what we get with Quest Analytics is going to be the same result we get when CMS or the state does it."**  
— Quest Analytics Client

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# "Quest Analytics is the gold standard, and the fact that CMS also utilizes them just made it a no-brainer."  
— Quest Analytics Client

## Federal Templates

**CMS** – Medicare Advantage  
**CCIIO** – Qualified Health Plan (QHP)

## State Templates

## California  
**CDI** – California Department of Insurance  
**DHCS** – Department of Health Care Services  
**DMHC** – Department of Managed Health Care

## Hawaii  
**Med-QUEST** – Medicaid

## Illinois  
**IL Medicaid**  
**DOI** (QHP) - Department of Insurance

**Louisiana**  
**LA Medicaid**

## Massachusetts  
**ACO MCO** – Accountable Care Organization, Managed Care Organization  
**MBHP** – Massachusetts Behavioral Health Partnership  
**MA SCO** – Senior Care Options

## MA OneCare

## Michigan  
**DHHS** – Department of Health and Human Services  
**DIFS** – Department of Insurance and Financial Services  
**DIFS PBM** - Department of Insurance and Financial Services  
**DH** (QHP) – Department of Health

## Minnesota

## Missouri  
**DSS** – Department of Social Services

## New Jersey  
**DOBI** – Department of Banking and Insurance

## New York  
**SDOH** – State Department of Health

## Ohio  
**DM PBM** – Department of Medicaid

## Pennsylvania  
**DHS** – Department of Human Services  
**DOH** (QHP) – Department of Health

## South Carolina  
**DHHS** – Department of Health and Human Services

## Texas  
**HHSC** – Health and Human Services Commission  
**TDI** – Department of Insurance

## Washington  
**HCA** – Healthcare Authority

## Wisconsin  
**BadgerCare** – Medicaid

## Custom Templates

Custom built templates using specialties and standards defined by your organization, provide you with essential tools needed for ongoing assessment of your network against regulatory criteria. Choose the adequacy analysis levels, such as county or zip code, and time and distance methodologies that align with your compliance management and analysis needs, and Quest will deliver the right templates to meet your needs.