hedis 2022 cheat sheet

0000021322 00000 n 0000309029 00000 n 0000313326 00000 n 0000005408 00000 n Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA. 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). Commercial specifications should be followed for all required HEDIS 2022 and QARR 2022 NYS-specific measures. digital device in . This Agreement is not intended to and shall not be construed to give any third party any interest or rights (including, without limitation, any third-party beneficiary rights) with respect to or in connection with any agreement or provision contained herein or contemplated hereby. 0000010194 00000 n 0000042169 00000 n 0000022901 00000 n HEDIS Volume 2 is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. 1. startxref 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). View our frequently asked questions. 0000043052 00000 n Optima Health 2023, 4417 Corporation Lane, Virginia Beach, VA 23462-3162. What is HEDIS HEDIS rates are the most widely used set of health care performance measures on important preventive and clinical services. 0000312102 00000 n 0000042754 00000 n 58 0 obj <> endobj xref 0000039575 00000 n 0000041110 00000 n 0000034483 00000 n Below is a summary of some of the key changes to be aware of: Diabetes measures. 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). 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. 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). xn0#eR;TUj!@iFQ;6t$-h4Lblp|FC''p6@b^{|K@i&!MBot&ji`Wix P)V(K+Yn*g^\(5%ha 1.833.LAC.DSNP (1-833-522-3767)(TTY 711)24 hours a day. endstream endobj startxref 0000004603 00000 n Have you tried MyHIM, our member wellness program? The License is limited subject to the following terms and conditions. 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. 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. Use of the Marks shall inure to the benefit of NCQA. 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. 0000312745 00000 n 2022. endobj Controlling High Blood 18 - 85 yrs. 2 0 obj L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. 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. 0000040496 00000 n 0000043726 00000 n 3 0 obj IMPORTANT: Are you enrolled in Medi-Cal? Most PDF readers are a free download. Administrative Measure Quick Guide with Codes . Has your contact information changed in the past two years? 0000039848 00000 n [ 0000043858 00000 n 0000039666 00000 n T 2022. with: Progress note with latest blood pressure reading taken in . 0000002956 00000 n 0000040184 00000 n 0 0000029735 00000 n Apr 1, 2022 Administrative. 0000309690 00000 n x\B+C8 ssVj'. 0000042635 00000 n 0000040859 00000 n Telehealth encounters in . 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). 0000306585 00000 n 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. 0000031213 00000 n 0000042498 00000 n , II fz4cFb'98}1m'Gv{YMvEH_Wma}hn'a^`lwZwRis-^sQF6'[ZR)kH6fW=gpO'/ n &a)^y`_O~~$H67XIkxz}qk7^UXYlP!Fc#jxw!W(E_4CvF4DnL))Tz2R8./SiV5,hKkO(|Q_Y{IWYj&Yp\2/3%XhWtt0E{At5n6E'>loT%/$[s7 ]c9~G The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. 0000310823 00000 n 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. 0000039017 00000 n 0000033741 00000 n 0000009121 00000 n L.A. Care is proud to participate in Covered California to offer affordable health insurance to Los Angeles County residents. 0000029274 00000 n 0000010761 00000 n 0000042011 00000 n TO THE MAXIMUM EXTENT ALLOWABLE BY LAW, THE PARTIES DISCLAIM THE APPLICABILITY OF THE UNIFORM COMMERCIAL CODE OR OTHER UNIFORM LAWS. %PDF-1.6 % Read this Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. Sole ownership rights to the Licensed Measure Specifications and any modifications, alterations or adjustments thereof reside with NCQA. %PDF-1.5 % Anyone contemplating a use beyond a personal, non-commercial use, including but not limited to a commercial use, internal or external reproduction, distribution or publication of any part of a product or use of a product to identify records or calculate HEDIS measure results, must contact the NCQA licensing team by submitting a request through https://my.ncqa.org to discuss the need for a license.Licensee agrees and understands that any score or numeric result calculated from access and use of HEDIS Volume 2 does not constitute a preliminary or final score and does not predict achievement of accreditation, certification or recognition, as applicable. 0000002209 00000 n Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health . trailer Compliance with these measures may reduce the need for you to send medical records later for review. 0000002081 00000 n endstream endobj 2212 0 obj <>/Filter/FlateDecode/Index[119 2008]/Length 63/Size 2127/Type/XRef/W[1 1 1]>>stream In effectuating its obligations hereunder, Licensee shall not consent to the entry of a judgment or otherwise settle any claim against NCQA, in which NCQA shall be obligated to make any admission of fault, liability or wrongdoing or otherwise involve any prejudice of its interests without the prior written consent of NCQA, which shall not be unreasonably withheld, delayed or conditioned. 0000310669 00000 n 0000012365 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 The report cards use a standard set of measures called the Healthcare Effectiveness Data and Information Set (HEDIS ).*. 0000004105 00000 n 1527 0 obj <>stream Rate 1: Six or more well-child visits* 0 to 15 months. 0000007396 00000 n 2022. This new site may be offered by a vendor or an independent third party. 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. 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. 0000072229 00000 n 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. 0000003478 00000 n Submit this inquiry by logging intoMy NCQA, selecting theAsk a Questionbutton, then theOrdersbutton, then theCustom License Requestsoption. 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. 0000043770 00000 n %PDF-1.6 % 0000012694 00000 n 0000023670 00000 n Read more about the HEDIS schedule changehere. 0000034562 00000 n 0000012472 00000 n 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. 0000018194 00000 n 0000307683 00000 n 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). Disclaimer: The summary specifications for measures reported using electronic clinical data systems (ECDS) that are included in the Volume 2 publication are for reference purposes only and should not be used for programming or reporting of the measures. 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. 0000043174 00000 n 0 hV PSW}I~B!i `!VDEeSpIQEF-@YBUDm_tw&s9 @@8 @L.i f,2e#/]DHVjI41;k!hM'% ALqnEyWyyrR}w05(Z2|D 0000011425 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. JavaScript seems to be disabled in your browser. Have questions about renewing your Medi-Cal? 0000032765 00000 n 0000108677 00000 n Unauthorized internal distribution of the publication and materials thereinbeyond the number of users licensed by your organizationis prohibited. 0000052324 00000 n 0000033025 00000 n 0000042712 00000 n -UN\\ZGI!.F@ wP{GG`EG P)9Pj ``^EX 0000011383 00000 n Helpful Hints 0000043946 00000 n 0000009862 00000 n Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Sentara Health Plans, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Optima Health Plan. 0000310525 00000 n Give your county office your updated contact information so you can stay enrolled. HEDIS is a nationally standardized set of measures related to important areas of care and service. 0000310375 00000 n 0000034689 00000 n 0000306723 00000 n Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. hXkTG/@$crvna%Ds]Tl For HEDIS related inquiries, please contact HEDIS_Ops@lacare.org. 0000037381 00000 n 0000039652 00000 n 0000000016 00000 n The National Committee for Quality Assurance (NCQA) developed the HEDIS measures. The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. 0000011157 00000 n 0000028427 00000 n 2127 0 obj <> endobj 0000013780 00000 n View Table of Contents for this Publication. 0000038514 00000 n 0000014908 00000 n NCQA has recommended 5 HEDIS measures be included beginning MY2022 with expectations to expand across a minimum of 15 measures by MY2024. 0000012545 00000 n To ACCEPT this Agreement, click the accompanying checkbox/button to accept the terms of this product, which will create a legal contract that will bind Licensee and NCQA. HEDIS is the measurement tool used by the nation s health plans to evaluate their performance in terms of clinical quality and customer service. H@z Pk4wXvTxv startxref The individual accepting this Agreement on behalf of Licensee represents that by electronically signing this Agreement, the individual hereby binds the Licensee to the terms of this Agreement, and that such individual is an employee of Licensee and duly authorized to enter into and bind Licensee to the terms of this Agreement. 0000004580 00000 n 0000016662 00000 n 0000040601 00000 n <> Licensee agrees to defend, indemnify and hold harmless NCQA and its directors, officers, employees and agents from and against any and all liability, loss, cost, expense (including reasonable attorney fees), damage, or claim asserted by any third party alleged to arise out of or otherwise relate to Licensees use, reproduction, distribution, incorporation or display of the Third-Party Codes. %%EOF endstream endobj 1350 0 obj <. %PDF-1.7 0 0000004280 00000 n h_HSQ]B,7=$,h5%A9(4zoIdXYT 0000039591 00000 n z$qP` .tu"#d4@IM`88dW]C'[Y_NH`x a 3NM2-o c;QAAQ[ fz:f d`} 9o0 mL endstream endobj 59 0 obj <>>> endobj 60 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page/PieceInfo>/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 0.0 0.0]>>/PageUIDList<0 278>>/PageWidthList<0 612.0>>>>>>>> endobj 61 0 obj <> endobj 62 0 obj <> endobj 63 0 obj <> endobj 64 0 obj <> endobj 65 0 obj <> endobj 66 0 obj <> endobj 67 0 obj <> endobj 68 0 obj [/ICCBased 91 0 R] endobj 69 0 obj <>stream 0000036187 00000 n 0000019655 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. 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. HEDIS MY2022. 0000308484 00000 n HEDIS Measures A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. 0000010923 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. 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. 1.2 Marks means the NCQA trademarks and/or service marks related to the Licensed Measure Specifications described in Section 5. The percentage of patients during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic 0000042661 00000 n trailer 0000026677 00000 n All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications and/or HEDIS VSD into any product or service to calculate measure results for customers for any purpose) and/or any 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. 0000003724 00000 n Failure to insist on strict performance of any term of this Agreement will not operate as a waiver of any subsequent default or failure of performance. 2022. What is HEDIS? 0000092876 00000 n 0000031527 00000 n 0000013873 00000 n 0000034181 00000 n HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting Copyright 2023 National Committee for Quality Assurance. 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 "R6!YV\#VAz\,E0Q{vrW7| 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. 0000308812 00000 n :u_qnDRXlg3ULQMEK:`tYme%4ot FbzX/t1&?(S3E,kmdoi'f3`]:XFQM8.?OJH49n0!+oj8)3QX&(WAa8\ ew[-|sHI&-](H$X :q3sK.9!1TQnv?5 }jdD9% .@>vSBkL-:\8Cf5*26 k~hr^=Ll i_5Ch'oY4[ 5* 0000033081 00000 n 0000014698 00000 n 1349 0 obj <> endobj 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. 0000012711 00000 n 0000108357 00000 n 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. 0000033339 00000 n 0000010787 00000 n Optima Preferred Provider Organization (PPO) products are issued and underwritten by Optima Health Insurance Company. 0000014954 00000 n 0000009238 00000 n 0000041544 00000 n Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the Agreement terms below. 0000013210 00000 n For the best experience on our site, be sure to turn on Javascript in your browser. 0000309871 00000 n HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . vital signs log in . i09}}y P 5 0000032997 00000 n 1171 0 obj <>stream 0000312403 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. 0000041498 00000 n HEDIS MY 2022 includes 96 measures across 6 domains of care: Effectiveness of Care Access/Availability of Care Experience of Care Utilization and Risk Adjusted Utilization Health Plan Descriptive Information Measures Reported Using Electronic Clinical Data Systems How is HEDIS Data Collected? 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"). 0000041331 00000 n <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %%EOF 0000036108 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. 0000040259 00000 n 0000031901 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.

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o[roJZ On*jdY>6P`ww]Kk|z{:G2B940x./?cq8L. 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. Use of the Marks shall inure to the benefit of NCQA. 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. 0000312745 00000 n 2022. endobj Controlling High Blood 18 - 85 yrs. 2 0 obj L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. 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. 0000040496 00000 n 0000043726 00000 n 3 0 obj IMPORTANT: Are you enrolled in Medi-Cal? Most PDF readers are a free download. Administrative Measure Quick Guide with Codes . Has your contact information changed in the past two years? 0000039848 00000 n [ 0000043858 00000 n 0000039666 00000 n T 2022. with: Progress note with latest blood pressure reading taken in . 0000002956 00000 n 0000040184 00000 n 0 0000029735 00000 n Apr 1, 2022 Administrative. 0000309690 00000 n x\B+C8 ssVj'. 0000042635 00000 n 0000040859 00000 n Telehealth encounters in . 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). 0000306585 00000 n 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. 0000031213 00000 n 0000042498 00000 n , II fz4cFb'98}1m'Gv{YMvEH_Wma}hn'a^`lwZwRis-^sQF6'[ZR)kH6fW=gpO'/ n &a)^y`_O~~$H67XIkxz}qk7^UXYlP!Fc#jxw!W(E_4CvF4DnL))Tz2R8./SiV5,hKkO(|Q_Y{IWYj&Yp\2/3%XhWtt0E{At5n6E'>loT%/$[s7 ]c9~G The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. 0000310823 00000 n 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. 0000039017 00000 n 0000033741 00000 n 0000009121 00000 n L.A. Care is proud to participate in Covered California to offer affordable health insurance to Los Angeles County residents. 0000029274 00000 n 0000010761 00000 n 0000042011 00000 n TO THE MAXIMUM EXTENT ALLOWABLE BY LAW, THE PARTIES DISCLAIM THE APPLICABILITY OF THE UNIFORM COMMERCIAL CODE OR OTHER UNIFORM LAWS. %PDF-1.6 % Read this Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. Sole ownership rights to the Licensed Measure Specifications and any modifications, alterations or adjustments thereof reside with NCQA. %PDF-1.5 % Anyone contemplating a use beyond a personal, non-commercial use, including but not limited to a commercial use, internal or external reproduction, distribution or publication of any part of a product or use of a product to identify records or calculate HEDIS measure results, must contact the NCQA licensing team by submitting a request through https://my.ncqa.org to discuss the need for a license.Licensee agrees and understands that any score or numeric result calculated from access and use of HEDIS Volume 2 does not constitute a preliminary or final score and does not predict achievement of accreditation, certification or recognition, as applicable. 0000002209 00000 n Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health . trailer Compliance with these measures may reduce the need for you to send medical records later for review. 0000002081 00000 n endstream endobj 2212 0 obj <>/Filter/FlateDecode/Index[119 2008]/Length 63/Size 2127/Type/XRef/W[1 1 1]>>stream In effectuating its obligations hereunder, Licensee shall not consent to the entry of a judgment or otherwise settle any claim against NCQA, in which NCQA shall be obligated to make any admission of fault, liability or wrongdoing or otherwise involve any prejudice of its interests without the prior written consent of NCQA, which shall not be unreasonably withheld, delayed or conditioned. 0000310669 00000 n 0000012365 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 The report cards use a standard set of measures called the Healthcare Effectiveness Data and Information Set (HEDIS ).*. 0000004105 00000 n 1527 0 obj <>stream Rate 1: Six or more well-child visits* 0 to 15 months. 0000007396 00000 n 2022. This new site may be offered by a vendor or an independent third party. 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. 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. 0000072229 00000 n 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. 0000003478 00000 n Submit this inquiry by logging intoMy NCQA, selecting theAsk a Questionbutton, then theOrdersbutton, then theCustom License Requestsoption. 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. 0000043770 00000 n %PDF-1.6 % 0000012694 00000 n 0000023670 00000 n Read more about the HEDIS schedule changehere. 0000034562 00000 n 0000012472 00000 n 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. 0000018194 00000 n 0000307683 00000 n 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). Disclaimer: The summary specifications for measures reported using electronic clinical data systems (ECDS) that are included in the Volume 2 publication are for reference purposes only and should not be used for programming or reporting of the measures. 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. 0000043174 00000 n 0 hV PSW}I~B!i `!VDEeSpIQEF-@YBUDm_tw&s9 @@8 @L.i f,2e#/]DHVjI41;k!hM'% ALqnEyWyyrR}w05(Z2|D 0000011425 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. JavaScript seems to be disabled in your browser. Have questions about renewing your Medi-Cal? 0000032765 00000 n 0000108677 00000 n Unauthorized internal distribution of the publication and materials thereinbeyond the number of users licensed by your organizationis prohibited. 0000052324 00000 n 0000033025 00000 n 0000042712 00000 n -UN\\ZGI!.F@ wP{GG`EG P)9Pj ``^EX 0000011383 00000 n Helpful Hints 0000043946 00000 n 0000009862 00000 n Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Sentara Health Plans, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Optima Health Plan. 0000310525 00000 n Give your county office your updated contact information so you can stay enrolled. HEDIS is a nationally standardized set of measures related to important areas of care and service. 0000310375 00000 n 0000034689 00000 n 0000306723 00000 n Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. hXkTG/@$crvna%Ds]Tl For HEDIS related inquiries, please contact HEDIS_Ops@lacare.org. 0000037381 00000 n 0000039652 00000 n 0000000016 00000 n The National Committee for Quality Assurance (NCQA) developed the HEDIS measures. The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. 0000011157 00000 n 0000028427 00000 n 2127 0 obj <> endobj 0000013780 00000 n View Table of Contents for this Publication. 0000038514 00000 n 0000014908 00000 n NCQA has recommended 5 HEDIS measures be included beginning MY2022 with expectations to expand across a minimum of 15 measures by MY2024. 0000012545 00000 n To ACCEPT this Agreement, click the accompanying checkbox/button to accept the terms of this product, which will create a legal contract that will bind Licensee and NCQA. HEDIS is the measurement tool used by the nation s health plans to evaluate their performance in terms of clinical quality and customer service. H@z Pk4wXvTxv startxref The individual accepting this Agreement on behalf of Licensee represents that by electronically signing this Agreement, the individual hereby binds the Licensee to the terms of this Agreement, and that such individual is an employee of Licensee and duly authorized to enter into and bind Licensee to the terms of this Agreement. 0000004580 00000 n 0000016662 00000 n 0000040601 00000 n <> Licensee agrees to defend, indemnify and hold harmless NCQA and its directors, officers, employees and agents from and against any and all liability, loss, cost, expense (including reasonable attorney fees), damage, or claim asserted by any third party alleged to arise out of or otherwise relate to Licensees use, reproduction, distribution, incorporation or display of the Third-Party Codes. %%EOF endstream endobj 1350 0 obj <. %PDF-1.7 0 0000004280 00000 n h_HSQ]B,7=$,h5%A9(4zoIdXYT 0000039591 00000 n z$qP` .tu"#d4@IM`88dW]C'[Y_NH`x a 3NM2-o c;QAAQ[ fz:f d`} 9o0 mL endstream endobj 59 0 obj <>>> endobj 60 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page/PieceInfo>/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 0.0 0.0]>>/PageUIDList<0 278>>/PageWidthList<0 612.0>>>>>>>> endobj 61 0 obj <> endobj 62 0 obj <> endobj 63 0 obj <> endobj 64 0 obj <> endobj 65 0 obj <> endobj 66 0 obj <> endobj 67 0 obj <> endobj 68 0 obj [/ICCBased 91 0 R] endobj 69 0 obj <>stream 0000036187 00000 n 0000019655 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. 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. HEDIS MY2022. 0000308484 00000 n HEDIS Measures A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. 0000010923 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. 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. 1.2 Marks means the NCQA trademarks and/or service marks related to the Licensed Measure Specifications described in Section 5. The percentage of patients during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic 0000042661 00000 n trailer 0000026677 00000 n All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications and/or HEDIS VSD into any product or service to calculate measure results for customers for any purpose) and/or any 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. 0000003724 00000 n Failure to insist on strict performance of any term of this Agreement will not operate as a waiver of any subsequent default or failure of performance. 2022. What is HEDIS? 0000092876 00000 n 0000031527 00000 n 0000013873 00000 n 0000034181 00000 n HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting Copyright 2023 National Committee for Quality Assurance. 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 "R6!YV\#VAz\,E0Q{vrW7| 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. 0000308812 00000 n :u_qnDRXlg3ULQMEK:`tYme%4ot FbzX/t1&?(S3E,kmdoi'f3`]:XFQM8.?OJH49n0!+oj8)3QX&(WAa8\ ew[-|sHI&-](H$X :q3sK.9!1TQnv?5 }jdD9% .@>vSBkL-:\8Cf5*26 k~hr^=Ll i_5Ch'oY4[ 5* 0000033081 00000 n 0000014698 00000 n 1349 0 obj <> endobj 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. 0000012711 00000 n 0000108357 00000 n 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. 0000033339 00000 n 0000010787 00000 n Optima Preferred Provider Organization (PPO) products are issued and underwritten by Optima Health Insurance Company. 0000014954 00000 n 0000009238 00000 n 0000041544 00000 n Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the Agreement terms below. 0000013210 00000 n For the best experience on our site, be sure to turn on Javascript in your browser. 0000309871 00000 n HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . vital signs log in . i09}}y P 5 0000032997 00000 n 1171 0 obj <>stream 0000312403 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. 0000041498 00000 n HEDIS MY 2022 includes 96 measures across 6 domains of care: Effectiveness of Care Access/Availability of Care Experience of Care Utilization and Risk Adjusted Utilization Health Plan Descriptive Information Measures Reported Using Electronic Clinical Data Systems How is HEDIS Data Collected? 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"). 0000041331 00000 n <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %%EOF 0000036108 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. 0000040259 00000 n 0000031901 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. %20Error During Websocket Handshake: Unexpected Response Code: 404, Church's Chicken Mac And Cheese Ingredients, Lake Bryan Orlando Fishing, Articles H
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