Optima Health Medicare, Medicaid, and FAMIS programs are administered under agreements with Optima Health and the Centers for Medicare and Medicaid Services (CMS) and the Virginia Department of Medical Assistance Services (DMAS). Any Organizations that need help determining how their use of NCQAs HEDIS measure specifications and Value Set Directories fit into NCQAs licensing and certification requirements should use theHEDIS Licensing Tool. 0000009238 00000 n 0000005121 00000 n 11. 0000036645 00000 n 0000020709 00000 n 0000043472 00000 n 8259 0 obj <> endobj 0000043397 00000 n 0000308347 00000 n 0000310375 00000 n Neither Party shall assign or otherwise delegate this Agreement or any rights, duties and/or obligations hereunder without the prior written consent of the other Party. 8314 0 obj <>stream The percentage of patients during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic 0000307059 00000 n Note:NCQA has updated the naming convention of HEDIS publications to refer to the measurement year (MY) for HEDIS measures. 0000021658 00000 n , II NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows: 1.1 Licensed Measure Specifications shall mean NCQAs HEDIS measures and specifications and HEDIS CAHPS survey measures and specifications detailed in HEDIS Volume 2 (including the Rules), subject to payment of any related fees. 0000024421 00000 n 0000009121 00000 n 0000106122 00000 n For the best experience on our site, be sure to turn on Javascript in your browser. NCQA warrants that the media on which HEDIS Volume 2 is furnished will be free of defects in materials and workmanship under normal use for a period of ninety (90) days from the date of purchase. 0000041171 00000 n 0000043858 00000 n 0000040496 00000 n 0000109341 00000 n %PDF-1.7 % 0000306886 00000 n 0000309524 00000 n 0000006919 00000 n 1407 121 All uses of such Third-Party Codes may require a license from the copyright owner, which Licensee acknowledges and agrees that it is solely responsible for obtaining directly from the copyright owners and that NCQA has no liability or responsibility for such Third-Party Codes or claims arising out of the use thereof by Licensee. 0000028129 00000 n 0000009376 00000 n L.A. Care is proud to participate in Covered California to offer affordable health insurance to Los Angeles County residents. startxref 0000010580 00000 n 0000312403 00000 n More than 90 percent of America's health plans use HEDIS to evaluate performance. X]E| iR*W1Fr!r"n,+K9*"-XjV=Q[OL]jPz[#5i#r?lBwEEa^ZcP"m)L=)/H!?>o[roJZ On*jdY>6P`ww]Kk|z{:G2B940x./?cq8L. "R6!YV\#VAz\,E0Q{vrW7| 2020 HEDIS Cheat Sheet Measure HEDIS Requirement Rendering Provider Needs to report W34 Well Child visits in ages 3-6 years of life Measures percentage of members 3 to 6 years of age who had one or more comprehensive well child visits with a PCP during the year. 0000041544 00000 n 0000042845 00000 n The License is not transferable from Licensee to any other person, entity, organization or association. 0000034181 00000 n 0000021645 00000 n 0000108743 00000 n The individual accepting this Agreement on behalf of Licensee represents that by electronically signing this Agreement, the individual hereby binds the Licensee to the terms of this Agreement, and that such individual is an employee of Licensee and duly authorized to enter into and bind Licensee to the terms of this Agreement. HL7 is the registered trademark of Health Level Seven International. HEDIS is a set of standardized measures that specifies how organizations collect, audit and report performance information across the most pressing clinical areas, as well as important dimensions of customer satisfaction and patient experience. bfLZiPnBFAJ@9KN2kl>xnxX:+spU||)p?@enq-}\pyPRaex6W~)(Ix/]fFxP0 0000311633 00000 n 0000027069 00000 n HEDIS Volume 2 and the Licensed Measure Specifications expressly exclude all third-party code values contained in the HEDIS VSD which are owned, licensed or otherwise provided by third parties and protected under federal copyright laws (Third-Party Codes). 0000006410 00000 n 0000106227 00000 n HEDIS Measures A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. B,2I#QayB\*@. 2022. qJ{*ay|UgxEjM&aMzw- hR ZMr 5TW[Q2\Cbyh|#my\?Qj**}g}F %%EOF View our frequently asked questions. HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures developed by the National Committee for Quality Assurance (NCQA) to objectively measure, report, and compare quality across health plans. 0000002209 00000 n H\n0E 2022. with: Progress note with latest blood pressure reading taken in . 0000000016 00000 n 0000004580 00000 n Documentation of LMP, EDD or gestational age, or 0000108677 00000 n 1349 0 obj <> endobj 0000312102 00000 n 0000038593 00000 n 0000040903 00000 n 0000007912 00000 n 2022. 2022. hb```B ce`aB-G_PG 0000308484 00000 n hbbd```b`` @$SdId:lZ ] DHV~'l g" 1D]3@{@Wn``W ! As a part of L. A. Care's initiative to improve quality of care to our members, these HEDIS (Healthcare Effectiveness Data and Information Set) reference guides for selected priority HEDIS measures are designed to help your practice provide the best quality care, in alignment with the HEDIS standards as well as with evidence-based clinical practice guidelines. 0000023670 00000 n Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results. 0000043682 00000 n Nothing in this Agreement shall grant, or shall be deemed to grant, to Licensee a right or license to use, reproduce, distribute, incorporate or display the Third-Party Codes. 0000042977 00000 n REQUIRED HEDIS1 AND CAHPS2 MEASURES FOR HEDIS REPORTING YEAR 2022 Summary of Changes to Measure List: Added the following measures. Telehealth encounters in . To DECLINE this Agreement, do not proceed and contact my.ncqa.org with any questions or concerns or request for a custom license agreement to meet your needs. Except for authorized Licensed Users, each person, entity, organization or association, including agents and consultants of the Licensee, is required to separately purchase a license to obtain and access HEDIS Volume 2. The clinical information provided is intended to aid in the understanding of HEDIS measures. To verify compliance with this Agreement, NCQA is granted the right, with prior notice and during normal business hours, to examine all relevant records of Licensee. For the best experience on our site, be sure to turn on Javascript in your browser. h1 04,n\GMyC. or. Subject to the terms and conditions of this Agreement, NCQA grants Licensee a personal, limited, non-exclusive, non-transferable license in the United States to use HEDIS Volume 2 during the term of this Agreement solely for internal, non-commercial purposes in accordance with the terms of this Agreement (the License). 0000004603 00000 n THE LIABILITY OF EITHER PARTY TO THE OTHER PARTY ARISING UNDER THIS AGREEMENT WHETHER IN CONTRACT, TORT, OR OTHERWISE SHALL BE LIMITED TO ACTUAL AND DIRECT DAMAGES. We created tip sheets to help you satisfy quality measures, including Healthcare Effectiveness Data and Information Set (HEDIS) measures* from the National Committee for Quality Assurance (NCQA). 0000021318 00000 n 0000029168 00000 n 0000309151 00000 n vtt4LJ0G4v@uE %%aP=PKhXZ`ZZZF&m sq/P"]@ A list of potential measures for initial stratification in MY2022 are as follows: Controlling High Blood Pressure (CBP) Comprehensive Diabetes Care (CDC) Antidepressant Medication Management (AMM) 0000012285 00000 n 0000042130 00000 n 0000043265 00000 n Compliance with these measures may reduce the need for you to send medical records later for review. 0000040859 00000 n 0000020999 00000 n 0000044201 00000 n L$8d^HA2^h[,=%!kSyG)Je;'_ )*+n=8PR!0wSWk cE"Mos_|%,plTowGw6H`@)K'Ixxl/hLW}NGhu6)_TrOsX}X%%Vp(G(Z$sE4io\V_3|]raigYZ]Wy>j(Sg+25K4 n/AWa?5$3/) YDD;&4DP&qyL+#^49y)9Ram#XiX}! Have you tried MyHIM, our member wellness program? 0000040716 00000 n 0000012694 00000 n 0000029485 00000 n 0000034562 00000 n 0000029274 00000 n 0000009879 00000 n To ACCEPT this Agreement, click the accompanying checkbox/button to accept the terms of this product, which will create a legal contract that will bind Licensee and NCQA. 0000106009 00000 n 0000005715 00000 n A dated graphic sheet . 0000108859 00000 n 0000010484 00000 n 0000023321 00000 n Submit this inquiry by logging intoMy NCQA, selecting theAsk a Questionbutton, then theOrdersbutton, then theCustom License Requestsoption. %%EOF 0000033255 00000 n 0000036187 00000 n Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional licensed user permissions via the NCQA Store. 0000015935 00000 n Order educational materials for your patients. Rate 1: Six or more well-child visits* 0 to 15 months. 0000034564 00000 n 0000043726 00000 n 0000042712 00000 n External link You are leaving this website/app (site). Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health . See how we support the vision of everyone having fair and just opportunities to be as healthy as possible. HEDIS/CAHPS Measures Required for HP AccreditationCommercial *The weight column indicates the weight of the item (maximum value = 3) in the overall score calculation. 0000019655 00000 n Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA. New HEDIS Measures for MY 2023 HEDIS Measure Descriptions Frequently Asked Questions CLINICAL REFERENCE Avoidance of Antibiotic Use Clinical Guidelines HEDIS Measures Immunization Schedules 0000309871 00000 n Read this Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. 0000013780 00000 n %PDF-1.6 % trailer <<544F2374A80A4621986B17D4733DBC3A>]/Prev 388715>> startxref 0 %%EOF 118 0 obj <>stream <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF HEDIS VOLUME 2. 0000013210 00000 n 0000032997 00000 n and improve Quality Incentive Program earnings potential through the use of HEDIS reference sheets that include: Measure descriptions Age ranges Billing and diagnosis codes for each measure Tips and strategies for improving measure performance Refer your patients for Health Education Services. 0000064508 00000 n <<3742E41188BCC64D926D69F1B7DDE543>]/Prev 282268/XRefStm 4469>> 0000042661 00000 n 0000019374 00000 n 0000006599 00000 n THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF HEDIS VOLUME 2 IS WITH THE LICENSEE. All questions, comments or notices concerning this Agreement shall be submitted to NCQA by Licensee via email at my.NCQA.org or via mail at NCQA, Attention: Information Products, 1100 13th Street NW, Third Floor, Washington, DC 20005. 0000038081 00000 n Height, weight, BMI percentile (use Z68.51-Z68.54) and nutrition (97802, 97803, 97804) and physical activity counseling (Z02.5, Z71.82) Lead Screening in Children: 0000002081 00000 n YHLdb91{ d 9 PB2%e'c%tPV Q>!dF7\-9.Tr/_HQtvdQY/1g`SEp/HUyG=K>[pCqKI9w4%Vt)l{I)s1(yzv]:L:/dkey~WlXvu5{ Any breach of this Agreement by Licensee may cause irreparable harm to NCQA for which no adequate remedy at law exists and may subject Licensee to injunctive relief and all legal and equitable remedies available to NCQA, including, but not limited to, recovery of all costs and expenses, including reasonable attorney's fees incurred because of any such legal action. 0000013020 00000 n 1111 61 0000041786 00000 n 0000042092 00000 n WHEREAS, NCQA is an independent non-profit organization widely recognized as the authority on the quality of health plans; WHEREAS, NCQA has developed specifications for the Healthcare Effectiveness Data and Information Set (HEDIS) measures and specifications to standardize the collection and reporting of health plan quality information and the survey specifications for the Consumer Assessment of Healthcare Providers and Systems (CAHPS); WHEREAS, NCQA publishes HEDIS Volume 2: Technical Specifications for Health Plans (HEDIS Volume 2) that includes the HEDIS Value Set Directory (HEDIS VSD) that crosswalks HEDIS to third party medical and billing codes; WHEREAS, HEDIS Volume 2 also includes the Rules for Allowable Adjustments of HEDIS (the Rules), that prescribes guidelines for adjusting NCQAs HEDIS measures and specifications; WHEREAS, Licensee desires to use HEDIS Volume 2; and. A required resource for anyone involved in collecting, calculating or submitting HEDIS data, HEDIS MY 2022 Volume 2 features the complete technical specifications for each measure. 0000014362 00000 n 0000313191 00000 n 0000010787 00000 n 0000012711 00000 n 0000106153 00000 n HEDIS Measure Guidelines for Behavioral Health Providers Adults' Access to Preventive/Ambulatory Health Services (AAP) Advanced Care Planning (ACP) Breast Cancer Screening (BCS-E) Depression Remission or Response for Adolescents and Adults (DRR-E) Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC) The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. View Table of Contents for this Publication. 0000310823 00000 n 0000029379 00000 n 0000036980 00000 n 0000308812 00000 n Upon termination of this Agreement, all rights under this Agreement, including the License, will cease. 0000039666 00000 n 1371 0 obj <>/Filter/FlateDecode/ID[<7F9DDD8800BFEE4C9404AE52E016A647><02E18FF8926EFD40AEA58E0129A180D3>]/Index[1349 36]/Info 1348 0 R/Length 110/Prev 309529/Root 1350 0 R/Size 1385/Type/XRef/W[1 3 1]>>stream 0000311155 00000 n 0000010426 00000 n THE USE OF THE LICENSED MEASURE SPECIFICATIONS IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. 0000043593 00000 n 0000040601 00000 n %PDF-1.5 % 0000031527 00000 n HEDIS MY 2022 Volume 2incorporates the following additional content, providing added value to our customers: The HEDIS measures and specifications contained in HEDIS Volume 2 publication were developed by and are owned by NCQA. 0000042208 00000 n Quality measures help ensure our members receive appropriate care. hUoKZ1Y8\..gM - Pu2&R;"pI3%8N`9ql(u[a3~pP. Specifications for the Medicare Health Outcomes Survey, Case Management (CM) and Long-Term Services and Supports (LTSS), Managed Behavioral Healthcare Organizations (MBHO), Utilization Management/Credentialing/Provider Network (UM/CR/PN), Credentials Verification Organizations (CVO), Patient-Centered Specialty Practice (PCSP), Quality Compass 2023 (MY 2022) Commercial, Quality Compass 2023 (MY 2022) Exchange Data File, Quality Compass 2023 (MY 2022) Member Experience Data Set, California Align Measure Perform (AMP) & Value Based Pay for Performance (VBP4P), Skip to the beginning of the images gallery. endobj 0000016645 00000 n AWARE- California Medical Association Foundation: Physician Resources, HEDIS MY 2023 Hybrid Measure Quick Guide with Codes, HEDIS MY 2023 Hybrid Measure Pocket Guide, HEDIS MY 2023 Administrative Measure Quick Guide with Codes, HEDIS MY 2023 Chart Submission Requirements, QI Interventions Reported by Top Performing IPAs, How to access Provider Opportunity/Gaps in Care Reports, HEDIS Tip Sheet: Timeliness of Prenatal Care, Preventive Care Documentation Flyers for Providers, Timely Access to Care Suggested Interventions for IPAs, Timely Access to Care Oversight & Monitoring PPG Training, Timely Access to Care Oversight & Monitoring FAQ, Slide Deck: Moving the Needle on Member Satisfaction. <>/Metadata 6463 0 R/ViewerPreferences 6464 0 R>> Optima Health 2023, 4417 Corporation Lane, Virginia Beach, VA 23462-3162. endstream endobj 1350 0 obj <. % 0000033138 00000 n 0000011225 00000 n 7 e># v3jDZE#VLFPq3O "{B hs` p$}$gi}3.a Q[TjX Hb)UF0 ]nX3"W`XLi"0Lkc@JeH,6dTj&RXeQP_R%M0z/lTY\>T`*-8Y{VH_1j-9l$U61u~ju\t'vQ4sZJ.QsKIhQv\!W0$lOGG%r2/8=q smB9cve5vsAnU36 E{(f4OL`NY65U%mfu x.fxEy:f,*&_%7cSaAzATC G'QNXpk:@8S. 0000307683 00000 n Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 0000011272 00000 n 3 0 obj The License is not transferable from Licensee to any other person, entity, organization or association. 0000014908 00000 n Licensee agrees to defend, indemnify and hold harmless NCQA and its directors, officers, employees and agents from and against any and all liability, loss, cost, expense (including reasonable attorney fees), damage, or claim asserted by any third party alleged to arise out of or otherwise relate to Licensees use, reproduction, distribution, incorporation or display of the Third-Party Codes. 0000307344 00000 n NCQAs name and logo, and all other names, logos, icons, trademarks, and/or service marks identifying NCQA and its programs, product(s) and services are proprietary trademarks of NCQA and any use not expressly provided for in this Agreement is strictly prohibited. 0000009862 00000 n The section headings contained in this Agreement are included for reference only and shall not affect the construction or interpretation of any term in this Agreement. rates. 0000093172 00000 n The National Committee for Quality Assurance (NCQA) has changed, revised, and retired HEDIS for measurement year 2022. For HEDIS related inquiries, please contact HEDIS_Ops@lacare.org. trailer 0000313076 00000 n 1.833.LAC.DSNP (1-833-522-3767)(TTY 711)24 hours a day. What is HEDIS? 0000310525 00000 n 0000012813 00000 n Definitions: 1.1 "Licensed Measure Specifications" shall mean NCQA's HEDIS measures and specifications and HEDIS CAHPS survey measures and specifications detailed in HEDIS Volume 2 (including the Rules), subject to payment of any related fees. This License Agreement, along with all materials referenced herein (Agreement), is a legal agreement between the individual or entity purchasing the license to use HEDIS Volume 2 (defined below) (hereinafter the Licensee) and the National Committee for Quality Assurance (NCQA). 0000013091 00000 n 0000312745 00000 n 0000043770 00000 n 0000011830 00000 n 0000043353 00000 n 0000312918 00000 n 0000308215 00000 n 0000004308 00000 n
Salem Oregon Police Accident Reports,
Pivotal Ventures Jobs,
Unique Wedding Venues In New Orleans,
Is My Child Securely Attached Quiz,
Articles H
