REQUIRED HEDIS1 AND CAHPS2 MEASURES FOR HEDIS REPORTING YEAR 2022 Summary of Changes to Measure List: Added the following measures. 0000034562 00000 n NCQA has recommended 5 HEDIS measures be included beginning MY2022 with expectations to expand across a minimum of 15 measures by MY2024. 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{ 0000040760 00000 n %PDF-1.6 % 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. 0000007623 00000 n 0000072352 00000 n o,;6iN?e/.y)>2-@%!H20C@eW D* G^ 0000034175 00000 n 1 0 obj 0000008420 00000 n 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. %%EOF Licensee agrees to maintain HEDIS Volume 2 in strict confidence and abide by all terms and conditions of this Agreement. 0000011272 00000 n 0000010580 00000 n 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. endobj 0000009093 00000 n 0000000016 00000 n %PDF-1.6 % Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results. 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. 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) 0000034483 00000 n 0000039666 00000 n 0000010020 00000 n xref 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. 0000032166 00000 n 0000310995 00000 n Billing Reference Sheets and Claims Submission and Guidelines, Pediatric Obesity Prevention and Treatment Toolkit. BP taken and reported by member using . 0000309339 00000 n 1. 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. hb```B ce`aB-G_PG <]/Prev 525985/XRefStm 2956>> 0000033741 00000 n 1.833.LAC.DSNP (1-833-522-3767)(TTY 711)24 hours a day. 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. Help your patients with redetermination. 0000037764 00000 n The clinical information provided is intended to aid in the understanding of HEDIS measures. 1527 0 obj <>stream 0000042712 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. NEITHER PARTY SHALL HAVE ANY LIABILITY FOR ANY INCIDENTAL, SPECIAL, CONSEQUENTIAL OR OTHER INDIRECT DAMAGES ARISING UNDER OR RELATED TO THIS AGREEMENT, WHETHER OR NOT THE PARTY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. 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. 0000033339 00000 n 0000027717 00000 n 0000002775 00000 n 0000041498 00000 n 0000106048 00000 n 0000004580 00000 n 0000026677 00000 n HEDIS CHEAT SHEET 2022 - 2023 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Documented yearly for ages 3-17. 0000012365 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. One option is Adobe Reader which has a built-in reader. 0000034814 00000 n It is not intended to influence clinical and coding judgment. hbbd```b`` @$SdId:lZ ] DHV~'l g" 1D]3@{@Wn``W ! All Optima Health plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. 0000037990 00000 n 0000308484 00000 n NCQA updated telehealth guidance in 40 HEDIS measures for HEDIS MYs 2020 and 2021. trailer Our staff of Certified Health Coaches and Registered Dietitians can help you reach your health goals. 0000092876 00000 n 0000106009 00000 n 0000012962 00000 n External link You are leaving this website/app (site). L.A. Care is proud to participate in Covered California to offer affordable health insurance to Los Angeles County residents. %PDF-1.7 0000042011 00000 n 0000040903 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. A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. 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 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. This information sheet is accurate as of the date it is published but may change as HEDIS measures are updated or based on other factors. 0000009862 00000 n vtt4LJ0G4v@uE %%aP=PKhXZ`ZZZF&m sq/P"]@ 1111 61 Have you tried MyHIM, our member wellness program? -UN\\ZGI!.F@ wP{GG`EG P)9Pj ``^EX <<3742E41188BCC64D926D69F1B7DDE543>]/Prev 282268/XRefStm 4469>> HEDISThe Healthcare Effectiveness Data and Information Set (HEDIS) is a registered trademark of NCQA. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. 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. 0000006410 00000 n Updates on HEDIS Measures MY2022 . 0000042331 00000 n 0000000016 00000 n 0000042754 00000 n 0000033138 00000 n 0000307846 00000 n %%EOF L.A. Care Health Plan, A Public Entity 2000-2023Local Initiative Health Authority For Los Angeles County, Clinical Tools to Help You Improve Outcomes, everyone having fair and just opportunities, Elevating the Safety Net 2020 Scholarship Recipients, Additional Elevating the Safety Net Programs, Elevating the Safety Net - Frequently Asked Questions, Elevating the Safety Net - Guiding Principles, Elevating the Safety Net 2018 Scholarship Recipients, Elevating the Safety Net 2019 Scholarship Recipients, Elevating the Safety Net 2021 Scholarship Recipients, Elevating the Safety Net 2022 Scholarship Recipients. For example, 2022 claims, encounters, and other HEDIS data are submitted throughout 2022. 0000041082 00000 n 0000041171 00000 n hUoKZ1Y8\..gM - Pu2&R;"pI3%8N`9ql(u[a3~pP. 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. 0000043549 00000 n 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. 0000313076 00000 n 0000005408 00000 n 0000011303 00000 n 7nuT.,qUN^UNws}a9z6^.WU'_, rQTULzX{3yq\9$`IKz128~LVPwZZ8/8}W6!e2=M!\K!;.^)`'>F=D;D5L>5PfOTx) 1384 0 obj <>stream 0000039017 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) 0000002338 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. 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. See how we support the vision of everyone having fair and just opportunities to be as healthy as possible. trailer <<544F2374A80A4621986B17D4733DBC3A>]/Prev 388715>> startxref 0 %%EOF 118 0 obj <>stream 0000004679 00000 n 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 0000024421 00000 n 0000312745 00000 n Helpful Hints Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the Agreement terms below. 0000020709 00000 n THE LIMITATIONS OF DAMAGES AND LIABILITIES SET FORTH IN THIS AGREEMENT ARE FUNDAMENTAL ELEMENTS OF THE BASIS OF THE BARGAIN BETWEEN NCQA AND LICENSEE. 0000002081 00000 n 0000029735 00000 n startxref endstream endobj 2212 0 obj <>/Filter/FlateDecode/Index[119 2008]/Length 63/Size 2127/Type/XRef/W[1 1 1]>>stream 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. 0000032123 00000 n 0000306585 00000 n Rate 2: Two additional well-child visits 15 to 30 months. 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. Any 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. 11. TO THE MAXIMUM EXTENT ALLOWABLE BY LAW, THE PARTIES DISCLAIM THE APPLICABILITY OF THE UNIFORM COMMERCIAL CODE OR OTHER UNIFORM LAWS. 0000041110 00000 n 0000003174 00000 n 0000010761 00000 n HEDIS Measures A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. L.A. Care rewards high performing physicians for providing quality care to our members. 0000040859 00000 n Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 0000042661 00000 n 0000022547 00000 n 0000009862 00000 n 0000031901 00000 n Use of the Marks shall inure to the benefit of NCQA. H\n0E 0 0000004308 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. <> qJ{*ay|UgxEjM&aMzw- hR ZMr 5TW[Q2\Cbyh|#my\?Qj**}g}F 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). endobj View our frequently asked questions. 0000021318 00000 n Upon termination of this Agreement, all rights under this Agreement, including the License, will cease. 0000109736 00000 n 0000004537 00000 n 0000017908 00000 n %PDF-1.5 % 0000033334 00000 n Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA. 0000014908 00000 n B,2I#QayB\*@. 0000021322 00000 n 0000032947 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 0000307212 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. 0000312918 00000 n Controlling High Blood 18 - 85 yrs. 0000040259 00000 n HEDIS MY2022. 0000023670 00000 n 0000012368 00000 n stream Make sure your medical records reflect the following:-A note indicating a visit to PCP 0000018194 00000 n 0000034332 00000 n trailer digital device in . NCQA and Licensee may be individually referred to as a Party, or collective, the Parties. 0000112852 00000 n 0000040540 00000 n 0000033807 00000 n 0000006599 00000 n 0000041005 00000 n 0000106122 00000 n 0000312102 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). 0000036108 00000 n An organizations licensed users may use the materials solely for an internal non-commercial purpose without obtaining NCQA approval. 0000306886 00000 n In addition, some sites may require you to agree to their terms of use and privacy policy. HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . 0000313465 00000 n 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. THE USE OF THE LICENSED MEASURE SPECIFICATIONS IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. 0000042208 00000 n 0000311155 00000 n In effectuating its obligations hereunder, the 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. The National Committee for Quality Assurance (NCQA) has changed, revised, and retired HEDIS for measurement year 2022. 0000033357 00000 n 0000018305 00000 n 0000043353 00000 n 0000003513 00000 n 0000021645 00000 n 2022-2023 This guide provides HEDIS coding information only, not necessarily payment guidance. Order educational materials for your patients. 0000009453 00000 n 0000041544 00000 n endstream endobj startxref 0000041331 00000 n 0000309524 00000 n 0000042092 00000 n 0000033025 00000 n 0000043182 00000 n Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. 0000010787 00000 n NCQA SHALL HAVE NO LIABILITY FOR ANY DAMAGES RESULTING FROM USE OR INTERPRETATION OF THE LICENSED MEASURE SPECIFICATIONS OR HEDIS VSD, INCLUDING BUT NOT LIMITED TO THE IMPACT, PROVISION OR STANDARD OF MEDICAL CARE, WHETHER OR NOT NCQA HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. A dated graphic sheet . 0000034689 00000 n 0000033926 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. cytology performed between 2020-2022. 0000311932 00000 n Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional licensed user permissions via the NCQA Store. 2022. with: Progress note with latest blood pressure reading taken in . 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.

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