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. 11. 0000032997 00000 n 0000056729 00000 n 0000039591 00000 n 0000033081 00000 n 1.2 Marks means the NCQA trademarks and/or service marks related to the Licensed Measure Specifications described in Section 5. 0000002081 00000 n 0 Recognizing that HEDIS measures have traditionally been specified for health plan reporting, NCQA developed the Rules for Allowable Adjustment of HEDIS to accommodate the application of HEDIS measures to various levels of the health care system for quality improvement initiatives. 0000041171 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. 0000042845 00000 n Give your county office your updated contact information so you can stay enrolled. 0000009121 00000 n The report cards use a standard set of measures called the Healthcare Effectiveness Data and Information Set (HEDIS ).*. 0000012962 00000 n 0000008197 00000 n Title to and full ownership of the Licensed Measure Specifications (and adjustments thereto) and all intellectual property rights therein (including, but not limited to, all copyrights, patent rights, and trade secret rights) belong to NCQA or NCQA has obtained the necessary rights in the Licensed Measure Specifications (except as otherwise set forth regarding third party copyright ownership of portions of the HEDIS VSD) to grant the rights and licenses set forth herein. rates. % !N8X efI~wh73Q>oVZ+ cmG!gV?ngR~7rUCZEOA`3t= pO] Vv 5wq26mxvBh. 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. 0000033357 00000 n 0000043770 00000 n 0000309151 00000 n 0000000016 00000 n 0000037498 00000 n <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 0000038081 00000 n The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. 0000000016 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. 0000021645 00000 n The HEDIS VSD is made available for customers that purchase a license for HEDIS Volume 2 from NCQA. 0000014908 00000 n 0000003432 00000 n 0000306723 00000 n -UN\\ZGI!.F@ wP{GG`EG P)9Pj ``^EX Health Net - Coverage for Every Stage of Life | Health Net 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. Follow HEDIS 2022 instructions regarding commercial POS products. The clinical information provided is intended to aid in the understanding of HEDIS measures. Licensee shall indemnify and hold harmless NCQA and its directors, officers and employees from and against any and all liability, loss, cost, expense (including reasonable attorney fees), damage, or claim (Losses), including any Losses asserted by third parties, in proportion to, and to the extent the Losses arise from / or relate to the Licensees breach of this Agreement. 0000029735 00000 n 0000014342 00000 n External link You are leaving this website/app (site). xref 0000005859 00000 n 0000041623 00000 n 0000311932 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. 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. 0000010465 00000 n Below is a summary of some of the key changes to be aware of: Diabetes measures. 0000006884 00000 n HL7 is the registered trademark of Health Level Seven International. Prohibited Use AcknowledgementAn organizations Licensed Users may use HEDIS Volume 2 solely for a personal non-commercial purpose without obtaining NCQA approval. Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health . MEASUREDESCRIPTION OF MEASUREDOCUMENTATION TIPSCOMPLIANCE CODES & MEASURE TIPS Prevention and Screening Cervical Cancer Screening (CCS)* 0000037764 00000 n 0000306585 00000 n Adults' Access to Preventive/Ambulatory Health Services (AAP) Description; Assesses the percentage of members 20 years and older who had an ambulatory or preventive care visit during the measurement year . 0000034564 00000 n HEDIS is a nationally standardized set of measures related to important areas of care and service. 0000020709 00000 n 0000041082 00000 n 0000041005 00000 n 0000034689 00000 n 0000040601 00000 n HEDISThe Healthcare Effectiveness Data and Information Set (HEDIS) is a registered trademark of NCQA. 0000009862 00000 n 0000010020 00000 n 0000039096 00000 n 0000040903 00000 n 2127 87 0000017908 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}! 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. 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. 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. 0000037913 00000 n 1349 0 obj <> endobj 0000307344 00000 n 0000039802 00000 n trailer For example, 2022 claims, encounters, and other HEDIS data are submitted throughout 2022. THE LIMITATIONS OF DAMAGES AND LIABILITIES SET FORTH IN THIS AGREEMENT ARE FUNDAMENTAL ELEMENTS OF THE BASIS OF THE BARGAIN BETWEEN NCQA AND LICENSEE. 0000036980 00000 n 0000310823 00000 n 0000043726 00000 n hXkTG/@$crvna%Ds]Tl See how we support the vision of everyone having fair and just opportunities to be as healthy as possible. 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. Help your patients with redetermination. Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. Order educational materials for your patients. 0000003174 00000 n The License is limited subject to the following terms and conditions. 0000017054 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. 0000106153 00000 n Unauthorized internal distribution of the publication and materials thereinbeyond the number of users licensed by your organizationis prohibited. 2022. Except as expressly authorized or provided for herein, Licensee shall: (i) only adjust the Licensed Measure Specifications, or any portion thereof, as permitted by the Rules;(ii) not delete or in any manner alter any notices, disclaimers or other legends contained in HEDIS Volume 2 or appearing on any screens, documents or other materials obtained through use of HEDIS Volume 2;(iii) prominently display language as displayed in Section 17 when adjusting the Licensed Measure Specifications as permitted by the Rules; (iv) not use HEDIS Volume 2 (including the Licensed Measure Specifications) or any portion thereof for any purpose other than as specifically set forth in this Agreement;(v) not publicly display, disseminate or publish the HEDIS Volume 2 (including the Licensed Measure Specifications), modifications or adjustments thereof or any portion of the same;(vi) not use the HEDIS VSD or any portion thereof without an authorized license from the copyright owners; (vii) not provide service bureau facilities or commercial time-sharing services to any third party or supporting operations for any third party through access and/or use of HEDIS Volume 2;(viii) not transmit HEDSI Volume 2 electronically or allow access to HEDIS Volume 2 over a network or a public computer-based information system which permits access to a greater number of users than licensed by Licensee; (ix) not authorize or permit any third-party or affiliate, subsidiary or related entity to use HEDIS Volume 2 (including the Licensed Measure Specifications) or any portion thereof without NCQA's prior written consent;(x) not identify records or calculate or display any calculated measurement (HEDIS measure result) stemming from the Licensed Measure Specifications;(xi) not reproduce, copy, reverse engineer, decompile or disassemble the Licensed Measure Specifications or prepare derivative works from the Licensed Measure Specifications or any portion thereof t (except that Licensee may make one [1] copy for each Licensed User for which Licensee has purchased a license to use HEDIS Volume 2); and(xii) not ship, transmit, transfer or export Volume 2 (including the Licensed Measure Specifications) or any portion thereof outside of the U.S. or to clients or other end-users primarily located outside of the U.S. 0000042011 00000 n 0000032765 00000 n endstream endobj startxref 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. 0000006599 00000 n Read this Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. trailer Molina Healthcare of California participates in HEDISas part of our State quality reporting No individual or entity may use HEDIS Volume 2 to evaluate another organization against NCQA standards, except as part of Licensees internal preparation for an NCQA survey or review.2. 0000033255 00000 n Apr 1, 2022 Administrative. 0000013361 00000 n No amendment, other modification or waiver of any term of this Agreement will be valid unless in writing signed by both parties. 0000010484 00000 n 0000026677 00000 n 0000004469 00000 n 0000043353 00000 n 0000009093 00000 n 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. 0000017945 00000 n 0000011225 00000 n 0000040184 00000 n Any 0000306886 00000 n This new site may be offered by a vendor or an independent third party. hb```b``e`c` @1v %M0-en{B)"p.1*'Y>Me}E;)2&u_hvO4Wu)4/Q%fV![\AE:-Trdc 0000310375 00000 n 0000032558 00000 n 0000109048 00000 n 0000002956 00000 n These Third-Party Codes may be protected under federal copyright laws and are included in HEDIS Volume 2 with the permission of the copyright owners. 8259 0 obj <> endobj H\n0E With respect to any and all claims brought by a third party, Licensee shall promptly notify NCQA of such claim and the Licensee shall have the right, at its sole discretion, to defend and control any action or proceeding with respect to such claim. [ 0000037990 00000 n 0000039848 00000 n 0000308347 00000 n Make sure your medical records reflect the following:-A note indicating a visit to PCP Documentation of LMP, EDD or gestational age, or WHEREAS, NCQA desires to provide Licensee with a license to use HEDIS Volume 2 in accordance with the terms of this Agreement. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. xn0#eR;TUj!@iFQ;6t$-h4Lblp|FC''p6@b^{|K@i&!MBot&ji`Wix P)V(K+Yn*g^\(5%ha Except where noted, the tip sheets include measure requirementsfor all our members including,all fully-insured PPO, Blue Choice PPOSMand HMO, Blue Cross Community Health PlansSM(BCCHPSM), Blue Cross Community MMAI (Medicare-Medicaid Plan)SMand Medicare Advantage members(unless otherwise specified). A dated graphic sheet . L.A. Care rewards high performing physicians for providing quality care to our members. More than 90 percent of America's health plans use HEDIS to evaluate performance. 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. 0000038002 00000 n 0000012472 00000 n endobj *i_k/ULV?v']+:9[VmCs>T1eANwI8e8`Fc1OK^As1(z}4==OQf*T",V/qq}%I XwsNL"~-u{UIppi/$&zh} 0000312918 00000 n L.A. 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To DECLINE this Agreement, do not proceed and contact my.ncqa.org with any questions or concerns or request for a custom license agreement to meet your needs. 0 For the best experience on our site, be sure to turn on Javascript in your browser. 0 0000108859 00000 n 0000308649 00000 n startxref 0000022782 00000 n 0000007580 00000 n 0000028129 00000 n <> 0000043682 00000 n Height, weight, BMI percentile (use Z68.51-Z68.54) and nutrition (97802, 97803, 97804) and physical activity counseling (Z02.5, Z71.82) Lead Screening in Children: 0000013780 00000 n 0000034175 00000 n This Agreement is deemed to be made under and shall be interpreted in accordance with the laws of the District of Columbia, without regard to its conflict of law principles. 0000109341 00000 n or. 0000008420 00000 n 0000012711 00000 n 0000036645 00000 n ' f it4A@! 0000029379 00000 n 0000311459 00000 n 0000004603 00000 n / 0000014954 00000 n Any use of HEDIS Volume 2 to identify records or calculate HEDIS measure results, for example, requires a custom license and may necessitate certification pursuant to NCQAs Measure Certification Program. 0000034483 00000 n 0000312403 00000 n Administrative Measure Quick Guide with Codes . If a required measure has only Medicaid specifications, commercial organizations 0000044201 00000 n 0000021024 00000 n 0000023670 00000 n stream 0000042667 00000 n Also, Licensee must prominently display the following notice near each adjusted Licensed Measure Specification using the Rules, or display as a footnote on each page in which an adjustment Licensed Measure Specification exists: The NCQA HEDIS measure specification has been adjusted pursuant to NCQAs Rules for Allowable Adjustments of HEDIS. 0000108743 00000 n h_HSQ]B,7=$,h5%A9(4zoIdXYT 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 0000313191 00000 n 0000021658 00000 n 2 0 obj 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). In addition, some sites may require you to agree to their terms of use and privacy policy. 0000024026 00000 n The License is not transferable from Licensee to any other person, entity, organization or association. 0000043902 00000 n 0000108357 00000 n 0000012368 00000 n 0000040760 00000 n 0000042889 00000 n 0000015921 00000 n 0000308812 00000 n 0000041498 00000 n HEDIS/CAHPS Measures Required for HP AccreditationCommercial *The weight column indicates the weight of the item (maximum value = 3) in the overall score calculation. 0000032947 00000 n 0000064508 00000 n 0000106009 00000 n 0000016961 00000 n 0000043814 00000 n 1111 61 0000040337 00000 n 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. trailer <<544F2374A80A4621986B17D4733DBC3A>]/Prev 388715>> startxref 0 %%EOF 118 0 obj <>stream NCQA is an independent, nonprofit organization. endobj 0000043052 00000 n 0000313076 00000 n 0000106227 00000 n 0000031527 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. 0000043397 00000 n A Licensed User must be using HEDIS Volume 2 under the License and solely on behalf of the Licensee. Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). x\B+C8 ssVj'. 0000093172 00000 n 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. 0000031213 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. 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. The following activities are expressly prohibited in connection with the use of HEDIS Volume 2 under this Agreement: 1. 2022. 0000036187 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. HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the health care quality. xref 0000072229 00000 n 0000031901 00000 n 0000033807 00000 n 0000011749 00000 n 0000311155 00000 n As a result, HEDIS is the ultimate measurable tool to evaluate provider's performance and quality of care. NCQA updated telehealth guidance in 40 HEDIS measures for HEDIS MYs 2020 and 2021. Has your contact information changed in the past two years? 0000039575 00000 n 2022-2023 This guide provides HEDIS coding information only, not necessarily payment guidance. The License is not transferable from Licensee to any other person, entity, organization or association. 0000309524 00000 n 8314 0 obj <>stream A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. 1.833.LAC.DSNP (1-833-522-3767)(TTY 711)24 hours a day. Licensee may use NCQAs registered trademark HEDIS only when describing the Licensed Measure Specifications as permitted under this Agreement, and to refer to the HEDIS measure specifications for the relevant year. This Publication License Agreement, along with all materials referenced herein ("License Agreement"), is a legal agreement between the individual or entity purchasing the license to use the Product (hereinafter the "Licensee") and the National Committee for Quality Assurance ("NCQA"). Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results. Commercial specifications should be followed for all required HEDIS 2022 and QARR 2022 NYS-specific measures. 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. 0000310525 00000 n 0000011140 00000 n 0000004679 00000 n Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA. endobj 0000006410 00000 n Note:NCQA has updated the naming convention of HEDIS publications to refer to the measurement year (MY) for HEDIS measures. Helpful Hints 0000033702 00000 n 0000033334 00000 n A Licensed User may not be an agent or consultant of a Licensee. 0000308048 00000 n NCQA and Licensee may be individually referred to as a Party, or collective, the Parties. 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{ 0000013099 00000 n The percentage of patients during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic HEDIS MY2022. Rate 2: Two additional well-child visits 15 to 30 months. 4 0 obj %%EOF 0000002209 00000 n 0000004718 00000 n %PDF-1.6 % 0000029168 00000 n 2022. with: Progress note with latest blood pressure reading taken in . %%EOF 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). 0000306648 00000 n One option is Adobe Reader which has a built-in reader. 0000040140 00000 n 0000042977 00000 n 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. 0000309339 00000 n 0000007623 00000 n 0000029274 00000 n 0000042710 00000 n NCQA has separated the Comprehensive Diabetes indicators into stand-alone measures: 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). 1527 0 obj <>stream 0000009879 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. 0000032123 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. 0000002338 00000 n 0000042933 00000 n The National Committee for Quality Assurance (NCQA) developed the HEDIS measures. Telehealth encounters in . 0000043989 00000 n 0000029485 00000 n 0000109736 00000 n 0000007396 00000 n In the event NCQA receives notification within the warranty period of any defects in the media, NCQA will, at its option, either replace such defective media or return to Licensee the price paid for HEDIS Volume 2.

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