Have questions about renewing your Medi-Cal? 0000013780 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. 0000112852 00000 n 1171 0 obj <>stream Help your patients with redetermination. 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). 0000014342 00000 n 0 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. 0000041498 00000 n 0000012365 00000 n Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health . 0000313191 00000 n 1384 0 obj <>stream 0000043052 00000 n H\n0E 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. 0000008420 00000 n stream 0000029274 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. 0000036187 00000 n Upon termination of this Agreement, all rights under this Agreement, including the License, will cease. 0000043549 00000 n 0000028129 00000 n 0000108933 00000 n Nothing in this Agreement shall grant, or shall be deemed to grant, to Licensee a right or license to use, reproduce, distribute, incorporate or display the Third-Party Codes. 0000004603 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. 0000052324 00000 n View our frequently asked questions. 0000013099 00000 n 0000010194 00000 n xn0#eR;TUj!@iFQ;6t$-h4Lblp|FC''p6@b^{|K@i&!MBot&ji`Wix P)V(K+Yn*g^\(5%ha The National Committee for Quality Assurance (NCQA) has changed, revised, and retired HEDIS for measurement year 2022. 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. 0000009862 00000 n 0000007912 00000 n BP taken and reported by member using . 0000064508 00000 n 0000009093 00000 n 0000006884 00000 n 0000021024 00000 n 0000021645 00000 n endstream endobj 1350 0 obj <. 0000043858 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). 0000310525 00000 n 0000031213 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. 0000311784 00000 n 0000039802 00000 n 0000011303 00000 n 1.833.LAC.DSNP (1-833-522-3767)(TTY 711)24 hours a day. 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. 0000043397 00000 n 0000010020 00000 n HEDIS MY2022. 0000004991 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. 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. 0000106009 00000 n Note:NCQA has updated the naming convention of HEDIS publications to refer to the measurement year (MY) for HEDIS measures. 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. %PDF-1.6 % 0000043182 00000 n %PDF-1.7 0000034175 00000 n <]/Prev 961931/XRefStm 4105>> hb```B ce`aB-G_PG 0000092876 00000 n 0000015577 00000 n 0000012573 00000 n 0000043309 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. 0000009376 00000 n The following sections shall survive termination of this Agreement: Sections 2, 6, 7, 8, 9, 10, 11, 12 and 18. We have a number of tools to help you boost HEDIS rates and increase your P4P award. Documentation in a standardized prenatal flow sheet, or; b. TO THE MAXIMUM EXTENT ALLOWABLE BY LAW, THE PARTIES DISCLAIM THE APPLICABILITY OF THE UNIFORM COMMERCIAL CODE OR OTHER UNIFORM LAWS. One option is Adobe Reader which has a built-in reader. 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. The License is not transferable from Licensee to any other person, entity, organization or association. x\B+C8 ssVj'. 0000040760 00000 n 0000024026 00000 n 0000013372 00000 n 0000307212 00000 n 0000039096 00000 n HEDIS MY 2022 . Telehealth encounters in . 0000308484 00000 n REQUIRED HEDIS1 AND CAHPS2 MEASURES FOR HEDIS REPORTING YEAR 2022 Summary of Changes to Measure List: Added the following measures. 0000040716 00000 n 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. 1111 61 0000024421 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). 0000313076 00000 n 0000014908 00000 n 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. 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. 0000042635 00000 n Documentation of LMP, EDD or gestational age, or 0000308215 00000 n 0000004580 00000 n / 1 0 obj 0000010484 00000 n 0000011830 00000 n 2021-2022 HEDIS and VBP TIP Sheet . 0000003724 00000 n 0000108677 00000 n ?t5o7~ 2l7~w3o0B3rq /3}1l?Fc % Npttr}>'1*ePXQl6?WDCBc68:_14%p{}8Tbj XkN,KrfNi+o 8259 0 obj <> endobj 0000041066 00000 n 0000106122 00000 n To view this file, you may need to install a PDF reader program. 58 61 0000019994 00000 n Read more about the HEDIS schedule changehere. Commercial specifications should be followed for all required HEDIS 2022 and QARR 2022 NYS-specific measures. qJ{*ay|UgxEjM&aMzw- hR ZMr 5TW[Q2\Cbyh|#my\?Qj**}g}F 0000033926 00000 n H@z Pk4wXvTxv 0000036645 00000 n Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA. 0000041623 00000 n 0000037913 00000 n 0000311459 00000 n 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. 7nuT.,qUN^UNws}a9z6^.WU'_, rQTULzX{3yq\9$`IKz128~LVPwZZ8/8}W6!e2=M!\K!;.^)`'>F=D;D5L>5PfOTx) 0000006654 00000 n 0000056729 00000 n HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . 0000016961 00000 n 0000043989 00000 n 1407 121 0000042542 00000 n endstream endobj startxref 0000040496 00000 n HEDISThe Healthcare Effectiveness Data and Information Set (HEDIS) is a registered trademark of NCQA. 0000034077 00000 n Any breach of this Agreement by Licensee may cause irreparable harm to NCQA for which no adequate remedy at law exists and may subject Licensee to injunctive relief and all legal and equitable remedies available to NCQA, including, but not limited to, recovery of all costs and expenses, including reasonable attorney's fees incurred because of any such legal action. oaoNNg. fz4cFb'98}1m'Gv{YMvEH_Wma}hn'a^`lwZwRis-^sQF6'[ZR)kH6fW=gpO'/ n &a)^y`_O~~$H67XIkxz}qk7^UXYlP!Fc#jxw!W(E_4CvF4DnL))Tz2R8./SiV5,hKkO(|Q_Y{IWYj&Yp\2/3%XhWtt0E{At5n6E'>loT%/$[s7 ]c9~G 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). 2022. 2022. 0000033339 00000 n 0000037990 00000 n 2213 0 obj <>stream 0000309029 00000 n 0000044158 00000 n trailer 0000033741 00000 n 0000041005 00000 n xref i09}}y P 5 0000108743 00000 n 0000022547 00000 n 0000017945 00000 n 0 0000043174 00000 n NCQA has separated the Comprehensive Diabetes indicators into stand-alone measures: Women 30-64 years of age who had cervical high-risk human papillomavirus (hrHPV) testing performed between 2018-2022. . It also includes general guidelines for data collection and reporting, detailed instructions about how to perform the necessary calculations and guidelines for sampling. 0000036108 00000 n Refer to your state's guidance for payment details and telehealth regulations. 0000013210 00000 n 0000106227 00000 n 0000006410 00000 n 0000037498 00000 n trailer <<544F2374A80A4621986B17D4733DBC3A>]/Prev 388715>> startxref 0 %%EOF 118 0 obj <>stream 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. Our staff of Certified Health Coaches and Registered Dietitians can help you reach your health goals. 0000033357 00000 n 0000004508 00000 n 0000310669 00000 n xref Molina Healthcare of California participates in HEDISas part of our State quality reporting 0000308649 00000 n %PDF-1.6 % 0000008197 00000 n If a required measure has only Medicaid specifications, commercial organizations Sole ownership rights to the Licensed Measure Specifications and any modifications, alterations or adjustments thereof reside with NCQA. 0000037613 00000 n 0000042375 00000 n Most PDF readers are a free download. <<3742E41188BCC64D926D69F1B7DDE543>]/Prev 282268/XRefStm 4469>> 11. 0000029735 00000 n hb```b``e`c` @1v %M0-en{B)"p.1*'Y>Me}E;)2&u_hvO4Wu)4/Q%fV![\AE:-Trdc Licensee agrees to maintain HEDIS Volume 2 in strict confidence and abide by all terms and conditions of this Agreement. The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. 0000310995 00000 n any. 0000307683 00000 n BECAUSE SOME STATES OR JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES, THE ABOVE LIMITATIONS MAY NOT APPLY TO LICENSEE. Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results. 2022. Use of the Marks shall inure to the benefit of NCQA. 0000005121 00000 n 0000042169 00000 n HEDIS is a nationally standardized set of measures related to important areas of care and service. A Licensed User may not be an agent or consultant of a Licensee. SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES . %%EOF 0000310045 00000 n 0000034483 00000 n 0000308347 00000 n 0000011225 00000 n Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. A Licensed User must be using HEDIS Volume 2 under the License and solely on behalf of the Licensee. 0000029168 00000 n 0000043814 00000 n L.A. Care rewards high performing physicians for providing quality care to our members. The adjusted measure specification may be used only for internal quality improvement purposes. The National Committee for Quality Assurance (NCQA) developed the HEDIS measures. 0000036980 00000 n NCQA updated telehealth guidance in 40 HEDIS measures for HEDIS MYs 2020 and 2021. 0000039575 00000 n 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. 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"). 0000042933 00000 n 0000310217 00000 n The clinical information provided is intended to aid in the understanding of HEDIS measures. 0000109736 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) See how we support the vision of everyone having fair and just opportunities to be as healthy as possible. 0000020709 00000 n 0000108859 00000 n 0000037764 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. 0000041742 00000 n Billing Reference Sheets and Claims Submission and Guidelines, Pediatric Obesity Prevention and Treatment Toolkit. The obligations of both Parties shall not terminate upon any assignment or delegation attempted without such prior written consent. % 0000311932 00000 n 0000312251 00000 n 0000018305 00000 n 0000008785 00000 n 4 0 obj 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. Unauthorized internal distribution of the publication and materials thereinbeyond the number of users licensed by your organizationis prohibited. 0000015935 00000 n 0000010465 00000 n 0000135675 00000 n 0000033334 00000 n 1527 0 obj <>stream 0000042661 00000 n 0000041082 00000 n Controlling High Blood 18 - 85 yrs. h_HSQ]B,7=$,h5%A9(4zoIdXYT %PDF-1.6 % 0000009879 00000 n 0000106153 00000 n 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. 0000038514 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 0000003478 00000 n 0000032558 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. trailer 1407 0 obj <> endobj Any CAHPSCAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional Licensed User permissions via the NCQA Store. 0000041375 00000 n Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional licensed user permissions via the NCQA Store. 0000005715 00000 n 0000015921 00000 n 0000000016 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. As a result, HEDIS is the ultimate measurable tool to evaluate provider's performance and quality of care. 0000309339 00000 n 0000033807 00000 n 0000019374 00000 n A dated graphic sheet . Have you tried MyHIM, our member wellness program? 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: Helpful Hints 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).