0000017945 00000 n 0000052324 00000 n HEDIS MY 2022 . 1349 0 obj <> endobj 0000041544 00000 n 0000002956 00000 n 0000003513 00000 n Sole ownership rights to the Licensed Measure Specifications and any modifications, alterations or adjustments thereof reside with NCQA. More than 90 percent of America's health plans use HEDIS to evaluate performance. 0000012365 00000 n 0000013099 00000 n 0000032947 00000 n 0000037613 00000 n Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. o,;6iN?e/.y)>2-@%!H20C@eW D* G^ 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. 0000007396 00000 n 1111 61 0000002775 00000 n startxref hXkTG/@$crvna%Ds]Tl 0000034564 00000 n -UN\\ZGI!.F@ wP{GG`EG P)9Pj ``^EX 0000024026 00000 n 0000308347 00000 n xref 0000312403 00000 n 0000043182 00000 n Read more about the HEDIS schedule changehere. 0000310045 00000 n <> Have questions about renewing your Medi-Cal? % oaoNNg. startxref 0000011383 00000 n 0000013091 00000 n 0000312745 00000 n 0000043130 00000 n 2020 HEDIS Cheat Sheet Measure HEDIS Requirement Rendering Provider Needs to report W34 Well Child visits in ages 3-6 years of life Measures percentage of members 3 to 6 years of age who had one or more comprehensive well child visits with a PCP during the year. 0000041742 00000 n 0000004280 00000 n Refer to your state's guidance for payment details and telehealth regulations. 0000010484 00000 n This Publication License Agreement, along with all materials referenced herein ("License Agreement"), is a legal agreement between the individual or entity purchasing the license to use the Product (hereinafter the "Licensee") and the National Committee for Quality Assurance ("NCQA"). 2022-2023 This guide provides HEDIS coding information only, not necessarily payment guidance. 0000007580 00000 n 0000008197 00000 n 3 0 obj 4 0 obj 0000012368 00000 n 2022. with: Progress note with latest blood pressure reading taken in . 0000003432 00000 n !N8X efI~wh73Q>oVZ+ cmG!gV?ngR~7rUCZEOA`3t= pO] Vv 5wq26mxvBh. 0000042331 00000 n 0000092606 00000 n HEDIS Volume 2 and the Licensed Measure Specifications expressly exclude all third-party code . 7nuT.,qUN^UNws}a9z6^.WU'_, rQTULzX{3yq\9$`IKz128~LVPwZZ8/8}W6!e2=M!\K!;.^)`'>F=D;D5L>5PfOTx) HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . %%EOF 0000009238 00000 n 1527 0 obj <>stream HEDIS MY2022. Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional licensed user permissions via the NCQA Store. 0000309524 00000 n 0000041621 00000 n 0000308649 00000 n 0000042208 00000 n 0000010761 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. 0000003724 00000 n 0000313326 00000 n %%EOF 0000009453 00000 n ' f it4A@! The License is not transferable from Licensee to any other person, entity, organization or association. 0000006919 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. 0000309029 00000 n 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). Help your patients with redetermination. 0000013210 00000 n SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES . 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. 0000042130 00000 n 2127 0 obj <> endobj HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting Quality measures help ensure our members receive appropriate care. vtt4LJ0G4v@uE %%aP=PKhXZ`ZZZF&m sq/P"]@ 0000043472 00000 n 0000037913 00000 n 0000012573 00000 n For example, 2022 claims, encounters, and other HEDIS data are submitted throughout 2022. The HEDIS VSD is made available for customers that purchase a license for HEDIS Volume 2 from NCQA. *i_k/ULV?v']+:9[VmCs>T1eANwI8e8`Fc1OK^As1(z}4==OQf*T",V/qq}%I XwsNL"~-u{UIppi/$&zh} The following sections shall survive termination of this Agreement: Sections 2, 6, 7, 8, 9, 10, 11, 12 and 18. 0000109341 00000 n 0000313465 00000 n 0000044201 00000 n 0000106227 00000 n 0000307344 00000 n Unauthorized internal distribution of the publication and materials thereinbeyond the number of users licensed by your organizationis prohibited. HEDIS is a nationally standardized set of measures related to important areas of care and service. PREVENTION AND SCREENING Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents Breast Cancer Screening Colorectal Cancer Screening Care for Older Adults RESPIRATORY 0000029168 00000 n Have you tried MyHIM, our member wellness program? 0000006599 00000 n 0000005121 00000 n 0000020709 00000 n 0000039802 00000 n 0000306886 00000 n endobj IN NO EVENT WILL NCQA'S TOTAL LIABILITY FOR ANY DIRECT DAMAGES RESULTING FROM ANY CLAIMS, DEMANDS OR ACTIONS ARISING OUT OF OR RELATING TO HEDIS VOLUME 2 OR ANY PART THEREOF, OR THIS AGREEMENT, EXCEED THE PRICE PAID FOR HEDIS VOLUME 2, WHETHER SUCH LIABILITY ARISES FROM ANY CLAIM BASED ON CONTRACT, WARRANTY, TORT OR OTHERWISE. Apr 1, 2022 Administrative. 0000029485 00000 n A dated graphic sheet . NCQA warrants that the media on which HEDIS Volume 2 is furnished will be free of defects in materials and workmanship under normal use for a period of ninety (90) days from the date of purchase. 0000106122 00000 n To view this file, you may need to install a PDF reader program. 0000043946 00000 n NCQA hereby grants to Licensee a non-exclusive, non-transferable license and right to display the below Marks solely in connection with the Licensed Measure Specifications as expressly permitted under this Agreement. Our staff of Certified Health Coaches and Registered Dietitians can help you reach your health goals. 0000004469 00000 n 0000011303 00000 n Rate 1: Six or more well-child visits* 0 to 15 months. %%EOF xn0#eR;TUj!@iFQ;6t$-h4Lblp|FC''p6@b^{|K@i&!MBot&ji`Wix P)V(K+Yn*g^\(5%ha Use of the Marks shall inure to the benefit of NCQA. 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. 0000042977 00000 n 0000033138 00000 n 0000308048 00000 n Make sure your medical records reflect the following:-A note indicating a visit to PCP Commercial specifications should be followed for all required HEDIS 2022 and QARR 2022 NYS-specific measures. 0000004580 00000 n %PDF-1.6 % Licensed Users mean Licensees employees who may access and use HEDIS Volume 2 on behalf of the Licensee. 0000005859 00000 n 0000309151 00000 n JavaScript seems to be disabled in your browser. 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. CAHPSCAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 0000005715 00000 n 0000309871 00000 n 0000011425 00000 n 0000307846 00000 n Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results. 0000012545 00000 n trailer 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. 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. 0000023321 00000 n As a part of L. A. Cares initiative to improve quality of care to our members, these HEDIS (Healthcare Effectiveness Data and Information Set) reference guides for selected priority HEDIS measures are designed to help your practice provide the best quality care, in alignment with the HEDIS standards as well as with evidence-based clinical practice guidelines. 0000004105 00000 n 0000042169 00000 n <>/Metadata 6463 0 R/ViewerPreferences 6464 0 R>> 1.833.LAC.DSNP (1-833-522-3767)(TTY 711)24 hours a day. 0 8288 0 obj <>/Filter/FlateDecode/ID[<69BCAFE65C18E142B8D25016BEF95C84><8F47EB867E2FB34A83FE6FC176ECE178>]/Index[8259 56]/Info 8258 0 R/Length 131/Prev 972378/Root 8260 0 R/Size 8315/Type/XRef/W[1 3 1]>>stream 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 USE OF THE LICENSED MEASURE SPECIFICATIONS IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. 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. 0000008420 00000 n 0000038081 00000 n endstream endobj 1350 0 obj <. hUoKZ1Y8\..gM - Pu2&R;"pI3%8N`9ql(u[a3~pP. 0000108743 00000 n 0000092876 00000 n 2022. 0000043814 00000 n <]/Prev 525985/XRefStm 2956>> 0000036108 00000 n The License is limited subject to the following terms and conditions. 0000011225 00000 n 8259 0 obj <> endobj 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. Below is a summary of some of the key changes to be aware of: Diabetes measures. Any 0000310995 00000 n 0000112852 00000 n hb```b``e`c` @1v %M0-en{B)"p.1*'Y>Me}E;)2&u_hvO4Wu)4/Q%fV![\AE:-Trdc See how we support the vision of everyone having fair and just opportunities to be as healthy as possible. hV PSW}I~B!i `!VDEeSpIQEF-@YBUDm_tw&s9 @@8 @L.i f,2e#/]DHVjI41;k!hM'% ALqnEyWyyrR}w05(Z2|D 0000010923 00000 n 0000029379 00000 n 0000109048 00000 n 0000039528 00000 n 0000042542 00000 n Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health . 0000014908 00000 n HEDIS Volume 2 and the Licensed Measure Specifications expressly exclude all third-party code values contained in the HEDIS VSD which are owned, licensed or otherwise provided by third parties and protected under federal copyright laws (Third-Party Codes). 0000021322 00000 n Billing Reference Sheets and Claims Submission and Guidelines, Pediatric Obesity Prevention and Treatment Toolkit. NCQA is an independent, nonprofit organization. 0000021645 00000 n 0000033081 00000 n 2 0 obj 0000036980 00000 n It is not intended to influence clinical and coding judgment. qJ{*ay|UgxEjM&aMzw- hR ZMr 5TW[Q2\Cbyh|#my\?Qj**}g}F No amendment, other modification or waiver of any term of this Agreement will be valid unless in writing signed by both parties. 0000036645 00000 n The adjusted measure specification may be used only for internal quality improvement purposes. 0000022547 00000 n HEDIS is the measurement tool used by the nation s health plans to evaluate their performance in terms of clinical quality and customer service. In addition, some sites may require you to agree to their terms of use and privacy policy. 0 0000041171 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. 0000039575 00000 n 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. 0000040003 00000 n 0000033741 00000 n Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the Agreement terms below. 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 Health Net - Coverage for Every Stage of Life | Health Net Licensee may not allow a third party to view or use HEDIS Volume 2. 0000011140 00000 n 0000311299 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. View Table of Contents for this Publication. 0 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. 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). A Licensed User may not be an agent or consultant of a Licensee. 0000006884 00000 n 0000040496 00000 n 0000010501 00000 n 0000011749 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. BP taken and reported by member using . 8314 0 obj <>stream 0000014954 00000 n 0000012962 00000 n 0000041331 00000 n The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. 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. 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. 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). 0000004603 00000 n 0000042889 00000 n 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). 0000022782 00000 n 0000012426 00000 n %PDF-1.7 0000038453 00000 n 0000012694 00000 n 0000004679 00000 n 0000042011 00000 n 0000106153 00000 n LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF HEDIS VOLUME 2. 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{ 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. 0000029274 00000 n 0000042845 00000 n Administrative Measure Quick Guide with Codes . 0000072229 00000 n 0000307212 00000 n 0000309339 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. 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. 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. 0000310217 00000 n 0000040716 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. 0000033334 00000 n The site may also contain non-Medicare related information. 0000043858 00000 n 0 0000042712 00000 n 0000033357 00000 n 2127 87 View our FAQs. 0000019374 00000 n 0000306648 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. 0 NCQA updated telehealth guidance in 40 HEDIS measures for HEDIS MYs 2020 and 2021. L.A. Care rewards high performing physicians for providing quality care to our members. h1 04,n\GMyC. 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. 0000034077 00000 n 0000002338 00000 n %%EOF 0000012813 00000 n 0000040859 00000 n 0000034175 00000 n 0000043682 00000 n 0000037498 00000 n 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). The obligations of both Parties shall not terminate upon any assignment or delegation attempted without such prior written consent.