Licensee agrees to maintain HEDIS Volume 2 in strict confidence and abide by all terms and conditions of this Agreement. 0000033339 00000 n Upon termination, Licensee agrees to immediately return to NCQA or destroy, at NCQAs option, all copies of HEDIS Volume 2, together with any back-up copy, modifications and any merged portions, in any form, in Licensee's possession. All other uses, including a commercial use (including but not limited to vendors or consultants using or embedding the measures and specifications and/or HEDIS VSD into any product or service to calculate measure results or provide any measure-related service to customers for any purpose) and/or any internal or external reproduction, distribution or publication (including but not limited to federal and state entities using or incorporating the measures into their programs) must be approved by NCQA and are subject to a license at the discretion of NCQA. 0000042055 00000 n 0000043052 00000 n 0000043130 00000 n rates. 0000313326 00000 n 0000311459 00000 n 0000004105 00000 n 0000005173 00000 n An organizations licensed users may use the materials solely for an internal non-commercial purpose without obtaining NCQA approval. Licensee agrees that it will not seek to register any of NCQAs Marks or other indicia consisting of or incorporating any element of the Marks, or variations thereof, in any jurisdictions. 0000039591 00000 n 0000042710 00000 n %PDF-1.6 % h1 04,n\GMyC. THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EITHER EXPRESS OR IMPLIED, AS RELATED TO HEDIS VOLUME 2 OR INFORMATION THEREIN, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. Prohibited Use AcknowledgementAn organizations Licensed Users may use HEDIS Volume 2 solely for a personal non-commercial purpose without obtaining NCQA approval. 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. 0000034564 00000 n 0000032123 00000 n 0000037613 00000 n 0000004537 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. any. startxref 0000308812 00000 n 0000040903 00000 n Controlling High Blood 18 - 85 yrs. NCQA MAKES NO WARRANTY, EXPRESS OR IMPLIED, WITH RESPECT TO THE LICENSED MEASURE SPECIFICATIONS OR ANY OTHER INFORMATION OR MATERIALS DELIVERED PURSUANT TO THIS AGREEMENT, INCLUDING WITHOUT LIMITATION ANY WARRANTY OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE, AND NCQA DISCLAIMS AND MAKES NO WARRANTY OR REPRESENTATIONS AS TO THE ACCURACY, QUALITY, RELIABILITY, SUITABILITY, COMPLETENESS, TRUTHFULNESS, USEFULNESS, OR EFFECTIVENESS OF THE LICENSED MEASURE SPECIFICATIONS. 8259 0 obj <> endobj CAHPSCAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 0000312403 00000 n 0000021645 00000 n 0000018194 00000 n BP taken and reported by member using . 0000106009 00000 n 2022 MEDICAID HEDIS REFERENCE SHEET FOR PROVIDERS 3 PEDIATRIC HEDIS MEASURES HEDIS MEASURE AGE MEASURE DESCRIPTION BILLING CODES WELL-VISIT Well Child Visits 0-30 Months of Life (W30) 0-30 months Telehealth exclusion removed. If a required measure has only Medicaid specifications, commercial organizations 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. 0000034332 00000 n 0000012285 00000 n 0000010484 00000 n 58 61 Optima Health 2023, 4417 Corporation Lane, Virginia Beach, VA 23462-3162. The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results. HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting NCQA hereby grants to Licensee a non-exclusive, non-transferable license and right to display the below Marks solely in connection with the Licensed Measure Specifications as expressly permitted under this Agreement. 0000004679 00000 n 0000042092 00000 n PREVENTION AND SCREENING Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents Breast Cancer Screening Colorectal Cancer Screening Care for Older Adults RESPIRATORY 0000043814 00000 n 0000042130 00000 n 0000034814 00000 n 0000311784 00000 n 0000052324 00000 n stream 0000043182 00000 n 0000009093 00000 n 0000009093 00000 n 0000017908 00000 n 8314 0 obj <>stream or. 0000106227 00000 n 0000032997 00000 n 0000042498 00000 n 0000040496 00000 n 0000004632 00000 n HEDIS is the gold standard in health care performance measurement, used by more than 90 percent of the nation's health plans and many leading employers and regulators. NCQA is an independent, nonprofit organization. x\B+C8 ssVj'. 0000009453 00000 n Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, Adult Access to Preventive/Ambulatory Health Services, Annual Dental Visit for Children and Adolescents, Appropriate Testing for Children with Pharyngitis, Appropriate Treatment for Upper Respiratory Infection, Kidney Health Evaluation for Patient with Diabetes, Use of Spirometry Testing in Assessing and Diagnosing COPD, Diabetes Screening forPeople with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications, Follow-Up After Emergency Department Visit for Substance Use, Follow-Up After Emergency Department Visit for Mental Illness, Follow Up After Hospitalization for Mental Illness, Follow-Up Care for Children Prescribed ADHD Medication, Initiation and Engagementof Substance Use DisorderTreatment, Metabolic Monitoring for Children and Adolescents on Antipsychotics, Social Need Screening and Intervention (SNS-E). SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES . 0000112852 00000 n %PDF-1.7 0000012962 00000 n Licensee Representation and Warranty: Licensee represents and warrants to NCQA that this Agreement shall be binding on Licensee, and, unless Licensee is an individual, Licensee represents and warrants that this Agreement was executed by an authorized signatory of Licensee with the authority to enter into binding agreements on behalf of Licensee. 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: 0000042933 00000 n 0000015921 00000 n 0000015577 00000 n 0000010020 00000 n 0000093172 00000 n 2022. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. 1407 0 obj <> endobj 0000310823 00000 n 0000014908 00000 n 0000041621 00000 n All Optima Health plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. The clinical information provided is intended to aid in the understanding of HEDIS measures. 0000027069 00000 n Follow HEDIS 2022 instructions regarding commercial POS products. HEDIS MY2022. 0000043353 00000 n %%EOF 0000037381 00000 n % 0000017945 00000 n 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. 0000308484 00000 n trailer HEDIS Volume 2 is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. 0000043265 00000 n Sentara Health Plans, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. 0 0000040337 00000 n trailer HEDIS Volume 2 contains proprietary and copyrighted information and notice to that effect must appear on all authorized copies of HEDIS Volume 2 (including the Licensed Measure Specifications) made by Licensee under this Agreement. Any use of HEDIS Volume 2 to identify records or calculate HEDIS measure results, for example, requires a custom license and may necessitate certification pursuant to NCQAs Measure Certification Program. External link You are leaving this website/app (site). 2022. 0000038081 00000 n 0000014698 00000 n 0000041742 00000 n 0000042331 00000 n hbbd```b`x"/I0yDHw`-R H2b;HWYH|&" 4H F ,{L `s?mm&F "3 0000028427 00000 n 2127 0 obj <> endobj 0000032166 00000 n 0000106048 00000 n 0000041082 00000 n 0000034689 00000 n 0000307059 00000 n Make sure your medical records reflect the following:-A note indicating a visit to PCP 0000013099 00000 n All notices to be given under this Agreement to Licensee shall be submitted by NCQA via e-mail at the account Licensee provided to NCQA. JavaScript seems to be disabled in your browser. 0000010194 00000 n Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional Licensed User permissions via the NCQA Store. No amendment, other modification or waiver of any term of this Agreement will be valid unless in writing signed by both parties. In January to May of 2023, data for 2022 continues to be submitted along with Medical Record review for Hybrid measures and final HEDIS 2022 rates and results are reported. The License is limited subject to the following terms and conditions. HEDIS/CAHPS Measures Required for HP AccreditationCommercial *The weight column indicates the weight of the item (maximum value = 3) in the overall score calculation. 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. 0000311299 00000 n 0000312745 00000 n View Table of Contents for this Publication. 0000312918 00000 n 0000040601 00000 n Helpful Hints 0000040540 00000 n HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . 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). 0000034483 00000 n 0000004580 00000 n IN NO EVENT WILL NCQA'S TOTAL LIABILITY FOR ANY DIRECT DAMAGES RESULTING FROM ANY CLAIMS, DEMANDS OR ACTIONS ARISING OUT OF OR RELATING TO HEDIS VOLUME 2 OR ANY PART THEREOF, OR THIS AGREEMENT, EXCEED THE PRICE PAID FOR HEDIS VOLUME 2, WHETHER SUCH LIABILITY ARISES FROM ANY CLAIM BASED ON CONTRACT, WARRANTY, TORT OR OTHERWISE. 0000041331 00000 n 0000312251 00000 n 0000012573 00000 n 0000034077 00000 n %PDF-1.6 % 0000005121 00000 n 0000309151 00000 n 0000040859 00000 n 0000003724 00000 n Health Net - Coverage for Every Stage of Life | Health Net 0000042635 00000 n digital device in . 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). 0000041110 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}! 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. 11. 0000043682 00000 n 0000043989 00000 n 0000000016 00000 n endstream endobj 1350 0 obj <. 0000010465 00000 n 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. 0000034562 00000 n 0000028129 00000 n 0000011749 00000 n 0000310525 00000 n 0000306648 00000 n IMPORTANT: Are you enrolled in Medi-Cal? 0000007623 00000 n 0000036187 00000 n 0000013210 00000 n endstream endobj startxref Quality measures help ensure our members receive appropriate care. 0000021322 00000 n 0000015935 00000 n 0000307344 00000 n 0000041786 00000 n 0000042977 00000 n This Agreement represents the complete agreement between the Parties concerning its subject matter and shall supersede all other agreements, whether written or oral, with respect to such subject matter, other than any nondisclosure or similar agreement, which shall remain in full force and effect. The following sections shall survive termination of this Agreement: Sections 2, 6, 7, 8, 9, 10, 11, 12 and 18. 0000013780 00000 n 0000040716 00000 n It also includes general guidelines for data collection and reporting, detailed instructions about how to perform the necessary calculations and guidelines for sampling. Rate 2: Two additional well-child visits 15 to 30 months. 0000006599 00000 n 1171 0 obj <>stream 0000043770 00000 n 0000037577 00000 n !N8X efI~wh73Q>oVZ+ cmG!gV?ngR~7rUCZEOA`3t= pO] Vv 5wq26mxvBh. 0000043549 00000 n 0000003174 00000 n In addition, some sites may require you to agree to their terms of use and privacy policy. 0000009376 00000 n <]/Prev 961931/XRefStm 4105>> Licensee may not allow a third party to view or use HEDIS Volume 2. Anyone contemplating a commercial use, or external reproduction, distribution or publication of any part of Volume 2, should not purchase HEDIS Volume 2 via the NCQA Store, and must contact the NCQA licensing teamto discuss the need for a license. 0000010426 00000 n 0000307683 00000 n HEDIS is a nationally standardized set of measures related to important areas of care and service. T HEDIS Volume 2 and the Licensed Measure Specifications expressly exclude all third-party code . 0000029274 00000 n NCQA has recommended 5 HEDIS measures be included beginning MY2022 with expectations to expand across a minimum of 15 measures by MY2024. More than 90 percent of America's health plans use HEDIS to evaluate performance. 1111 0 obj <> endobj 0000011027 00000 n 0000039528 00000 n endobj 0000014362 00000 n To view this file, you may need to install a PDF reader program. 0000004308 00000 n 0000307846 00000 n Also, Licensee must prominently display the following notice near each adjusted Licensed Measure Specification using the Rules, or display as a footnote on each page in which an adjustment Licensed Measure Specification exists: The NCQA HEDIS measure specification has been adjusted pursuant to NCQAs Rules for Allowable Adjustments of HEDIS. 0000004778 00000 n 0000040184 00000 n A Licensed User may not be an agent or consultant of a Licensee. We have a number of tools to help you boost HEDIS rates and increase your P4P award. The National Committee for Quality Assurance (NCQA) developed the HEDIS measures. 0000012426 00000 n 0000012694 00000 n 0000019655 00000 n 0000023670 00000 n endobj The HEDIS VSD is published as part of HEDIS Volume 2 and contains Third-Party Codes, including without limitation CPT by American Medical Association, LOINC by Regenstrief Institute, Inc., SNOMED CT by the International Health Terminology Standards Development Organisation, RxNorm by the U.S. National Library of Medicine and Uniform Billing Codes by the American Hospital Association. 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Note:NCQA has updated the naming convention of HEDIS publications to refer to the measurement year (MY) for HEDIS measures. xref 0000041171 00000 n 0000038593 00000 n If any portion of this Agreement is determined by a court of competent jurisdiction or any appropriate legislature or governmental agency to be wholly or partially unenforceable, for any reason, such term shall be deemed to be modified to the minimum extent necessary to comply with such law, ruling or regulation, and the remainder of this Agreement shall not be affected thereby. 1 0 obj WHEREAS, NCQA desires to provide Licensee with a license to use HEDIS Volume 2 in accordance with the terms of this Agreement. 0000024421 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 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. 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. 0000038514 00000 n 0000011140 00000 n 1384 0 obj <>stream This new site may be offered by a vendor or an independent third party. 0000043174 00000 n Our staff of Certified Health Coaches and Registered Dietitians can help you reach your health goals. BECAUSE SOME STATES OR JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES, THE ABOVE LIMITATIONS MAY NOT APPLY TO LICENSEE. 1.833.LAC.DSNP (1-833-522-3767)(TTY 711)24 hours a day. 2022. 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. 0000018305 00000 n 0000040003 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 site may also contain non-Medicare related information. hb```B ce`aB-G_PG New HEDIS Measures for MY 2023 HEDIS Measure Descriptions Frequently Asked Questions CLINICAL REFERENCE Avoidance of Antibiotic Use Clinical Guidelines HEDIS Measures Immunization Schedules 0000106153 00000 n 0000311633 00000 n 0000108859 00000 n hb```b``e`c` @1v %M0-en{B)"p.1*'Y>Me}E;)2&u_hvO4Wu)4/Q%fV![\AE:-Trdc 0000043472 00000 n 0000039802 00000 n 0000002956 00000 n 0000004991 00000 n %PDF-1.6 % 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 spider solitaire solver, burnley fc academy coaches, massage bradenton, fl,