Claims Development Management, LLC (CDM), a recognized leader in utilization management services, proudly announces that it has once again earned NCQA Utilization Management Accreditation in 2025—achieving a perfect score for the second consecutive time. This milestone marks ten years of continuous accreditation by the National Committee for Quality Assurance (NCQA), further solidifying CDM’s reputation for delivering exceptional healthcare services.
Receiving 100% compliance across all standards in back-to-back surveys is a rare and remarkable feat—one that reflects CDM’s unwavering dedication to clinical quality, operational excellence, and member-centered care.
"Achieving a perfect score once is a tremendous accomplishment. Doing it twice in a row is a testament to the strength of our team, our processes, and our commitment to doing right by the members and providers we serve," said Dr. Thao Tran, Chief Medical and Quality Officer. “This accreditation validates our mission to lead with integrity, precision, and compassion in every utilization decision we make."
CDM’s Utilization Management program is critical in ensuring that healthcare services are appropriate, evidence-based, and effectively managed. Through a robust mix of preservice and retrospective reviews, the organization partners with health plans and provider networks to optimize care delivery while fully complying with evolving regulatory and accreditation standards.
Since receiving its first NCQA accreditation in 2015, CDM has maintained an unbroken streak—underscoring a decade of proven performance and trust in the healthcare industry.
A key strategic partner is Provider Network Solutions, LLC (PNS), a leading value-based specialty care management organization. CDM supports PNS in managing utilization functions for a network of over 3.5 million specialty lives and more than 2,000 specialty providers.
About NCQA
NCQA is a private, nonprofit 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®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.
About Claims Development Management (CDM)
Founded in 2013, CDM provides expert utilization management services that improve care coordination, ensure medical necessity, and support value-based care initiatives. CDM’s work is aligned with NCQA’s mission to improve healthcare quality and the Institute for Healthcare Improvement’s Triple Aim: improving the patient experience, improving population health, and reducing healthcare costs.
About Provider Network Solutions (PNS)
Provider Network Solutions (PNS) is a leading value-based specialty care management organization founded in Florida in 1998. With a robust network of over 2,000 specialty providers and more than 3.5 million covered lives, through its specialty care networks, PNS partners with payors to enhance care access, improve clinical outcomes, and drive value through advanced analytics, risk management, and quality-driven initiatives. By focusing on innovation and sustainable healthcare transformation, PNS continues to lead in delivering high-quality specialty care.
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Media Contact:
Alexandra Salazar
Phone: 888-959-8714 x120
Email: alexandra@cdc.tpa.com
