0000002775 00000 n NCQA and Licensee may be individually referred to as a Party, or collective, the Parties. 0000040601 00000 n or. 0000042542 00000 n 0000311784 00000 n % 0000042331 00000 n 8259 0 obj <> endobj 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. %PDF-1.7 % SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES . 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). 0000005408 00000 n 0000308347 00000 n 11. 0000009093 00000 n Licensee may not allow a third party to view or use HEDIS Volume 2. 0000031213 00000 n Copyright 2023 National Committee for Quality Assurance. 1.2 Marks means the NCQA trademarks and/or service marks related to the Licensed Measure Specifications described in Section 5. xn0#eR;TUj!@iFQ;6t$-h4Lblp|FC''p6@b^{|K@i&!MBot&ji`Wix P)V(K+Yn*g^\(5%ha 3 0 obj Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 0000106227 00000 n HEDISThe Healthcare Effectiveness Data and Information Set (HEDIS) is a registered trademark of NCQA. 0000041498 00000 n 0000044158 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. 0000005715 00000 n trailer <<544F2374A80A4621986B17D4733DBC3A>]/Prev 388715>> startxref 0 %%EOF 118 0 obj <>stream 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. hUoKZ1Y8\..gM - Pu2&R;"pI3%8N`9ql(u[a3~pP. HEDIS Volume 2 is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. 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. L.A. Care is proud to participate in Covered California to offer affordable health insurance to Los Angeles County residents. 0000008197 00000 n 0000007396 00000 n 0000042754 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. 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. endstream endobj startxref 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. 0000015577 00000 n 0000310995 00000 n 0000309339 00000 n A dated graphic sheet . 1407 121 Have you tried MyHIM, our member wellness program? The following activities are expressly prohibited in connection with the use of HEDIS Volume 2 under this Agreement: 1. 0000043770 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. 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. xref 0000009121 00000 n Rate 1: Six or more well-child visits* 0 to 15 months. 0000044201 00000 n Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA. 0000004308 00000 n 7nuT.,qUN^UNws}a9z6^.WU'_, rQTULzX{3yq\9$`IKz128~LVPwZZ8/8}W6!e2=M!\K!;.^)`'>F=D;D5L>5PfOTx) 0000106122 00000 n 0000309871 00000 n hb```b``e`c` @1v %M0-en{B)"p.1*'Y>Me}E;)2&u_hvO4Wu)4/Q%fV![\AE:-Trdc 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. 0000009238 00000 n 0000108933 00000 n 0000311932 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 To view this file, you may need to install a PDF reader program. BECAUSE SOME STATES OR JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES, THE ABOVE LIMITATIONS MAY NOT APPLY TO LICENSEE. One option is Adobe Reader which has a built-in reader. 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. 0000042661 00000 n 0000006919 00000 n External link You are leaving this website/app (site). trailer The License is not transferable from Licensee to any other person, entity, organization or association. HL7 is the registered trademark of Health Level Seven International. 0000042712 00000 n oaoNNg. 0000042092 00000 n What is HEDIS? 58 0 obj <> endobj xref For the best experience on our site, be sure to turn on Javascript in your browser. Give your county office your updated contact information so you can stay enrolled. 0000109736 00000 n 0000037577 00000 n 2022. %%EOF 0000313191 00000 n 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) 0000039096 00000 n This Agreement is deemed to be made under and shall be interpreted in accordance with the laws of the District of Columbia, without regard to its conflict of law principles. Sign up for or check out past quality improvement webinars on topics ranging from diabetes care to data submission. 0000002338 00000 n 0000040337 00000 n Molina Healthcare of California participates in HEDISas part of our State quality reporting Refer to your state's guidance for payment details and telehealth regulations. 0000003513 00000 n 0000093172 00000 n 0000037913 00000 n Have questions about renewing your Medi-Cal? 0000009862 00000 n 0000037381 00000 n The National Committee for Quality Assurance (NCQA) has changed, revised, and retired HEDIS for measurement year 2022. 0000038514 00000 n startxref NCQA is an independent, nonprofit organization. 0000043814 00000 n rates. *i_k/ULV?v']+:9[VmCs>T1eANwI8e8`Fc1OK^As1(z}4==OQf*T",V/qq}%I XwsNL"~-u{UIppi/$&zh} Health Net - Coverage for Every Stage of Life | Health Net 0000042667 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. 1111 0 obj <> endobj The License is limited subject to the following terms and conditions. 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. 0000003174 00000 n 0000310823 00000 n 0000004632 00000 n The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. 1384 0 obj <>stream endobj 0000042498 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. MEASUREDESCRIPTION OF MEASUREDOCUMENTATION TIPSCOMPLIANCE CODES & MEASURE TIPS Prevention and Screening Cervical Cancer Screening (CCS)* vital signs log in . 0000012694 00000 n L.A. Care rewards high performing physicians for providing quality care to our members. 0000006654 00000 n 0000042889 00000 n Administrative Measure Quick Guide with Codes . 0000043174 00000 n 0000108357 00000 n To DECLINE this Agreement, do not proceed and contact my.ncqa.org with any questions or concerns or request for a custom license agreement to meet your needs. 0000005121 00000 n 0000021658 00000 n 0000042933 00000 n 0000004508 00000 n ' f it4A@! 0000043858 00000 n <> In the event NCQA receives notification within the warranty period of any defects in the media, NCQA will, at its option, either replace such defective media or return to Licensee the price paid for HEDIS Volume 2. 0000007912 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. %PDF-1.6 % What is HEDIS HEDIS rates are the most widely used set of health care performance measures on important preventive and clinical services. 0000005859 00000 n The clinical information provided is intended to aid in the understanding of HEDIS measures. View our frequently asked questions. 0000023670 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. If a required measure has only Medicaid specifications, commercial organizations THE USE OF THE LICENSED MEASURE SPECIFICATIONS IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. 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. L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you. 0000007580 00000 n B,2I#QayB\*@. 0000042130 00000 n xref Optima Health 2023, 4417 Corporation Lane, Virginia Beach, VA 23462-3162. 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. Help your patients with redetermination. 0000010194 00000 n 0000043397 00000 n 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. 0000043052 00000 n The adjusted measure specification may be used only for internal quality improvement purposes. 0000032765 00000 n 0000006410 00000 n Read more about the HEDIS schedule changehere. 0000004469 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. %PDF-1.7 HEDIS Volume 2 and the Licensed Measure Specifications expressly exclude all third-party code . 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. More than 90 percent of America's health plans use HEDIS to evaluate performance. HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting Sole ownership rights to the Licensed Measure Specifications and any modifications, alterations or adjustments thereof reside with NCQA. 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. 0000036187 00000 n 0000014698 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. qJ{*ay|UgxEjM&aMzw- hR ZMr 5TW[Q2\Cbyh|#my\?Qj**}g}F 0000011140 00000 n 2213 0 obj <>stream startxref 0000003724 00000 n 0000135675 00000 n 0000041331 00000 n 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 As a part of L. A. Care's 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. 0000010923 00000 n We have a number of tools to help you boost HEDIS rates and increase your P4P award. 0000312251 00000 n / 0000014908 00000 n Updates on HEDIS Measures MY2022 . See how we support the vision of everyone having fair and just opportunities to be as healthy as possible. 0000033339 00000 n <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 0000010787 00000 n 0000306585 00000 n No amendment, other modification or waiver of any term of this Agreement will be valid unless in writing signed by both parties. 0000011830 00000 n Documentation of LMP, EDD or gestational age, or 0000306886 00000 n View our FAQs. 0000040259 00000 n 0000004580 00000 n Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional licensed user permissions via the NCQA Store. 0000306648 00000 n It is not intended to influence clinical and coding judgment. 0000011894 00000 n 0000034814 00000 n :u_qnDRXlg3ULQMEK:`tYme%4ot FbzX/t1&?(S3E,kmdoi'f3`]:XFQM8.?OJH49n0!+oj8)3QX&(WAa8\ ew[-|sHI&-](H$X :q3sK.9!1TQnv?5 }jdD9% .@>vSBkL-:\8Cf5*26 k~hr^=Ll i_5Ch'oY4[ 5* NCQA updated telehealth guidance in 40 HEDIS measures for HEDIS MYs 2020 and 2021. Failure to insist on strict performance of any term of this Agreement will not operate as a waiver of any subsequent default or failure of performance. 0000311459 00000 n 0000024026 00000 n Documentation in a standardized prenatal flow sheet, or; b. Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Sentara Health Plans, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Optima Health Plan. Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the Agreement terms below. Billing Reference Sheets and Claims Submission and Guidelines, Pediatric Obesity Prevention and Treatment Toolkit. 0000020709 00000 n Apr 1, 2022 Administrative. 0000041786 00000 n 0000032947 00000 n 0000034077 00000 n In effectuating its obligations hereunder, the Licensee shall not consent to the entry of a judgment or otherwise settle any claim against NCQA, in which NCQA shall be obligated to make any admission of fault, liability or wrongdoing or otherwise involve any prejudice of its interests, without the prior written consent of NCQA, which shall not be unreasonably withheld, delayed or conditioned. 0000307514 00000 n 0000009093 00000 n 0000031527 00000 n !N8X efI~wh73Q>oVZ+ cmG!gV?ngR~7rUCZEOA`3t= pO] Vv 5wq26mxvBh. 0000312403 00000 n Any 0000000016 00000 n hXkTG/@$crvna%Ds]Tl Any use of HEDIS Volume 2 to identify records or calculate HEDIS measure results, for example, requires a custom license and may necessitate certification pursuant to NCQAs Measure Certification Program. 0000308215 00000 n 0000004537 00000 n 0000042710 00000 n 0000052324 00000 n 0000012545 00000 n HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . 1.833.LAC.DSNP (1-833-522-3767)(TTY 711)24 hours a day. 0000056729 00000 n 1407 0 obj <> endobj Licensee agrees to maintain HEDIS Volume 2 in strict confidence and abide by all terms and conditions of this Agreement. Follow HEDIS 2022 instructions regarding commercial POS products. Has your contact information changed in the past two years? 0000029168 00000 n 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. 0000039652 00000 n 0000040540 00000 n IMPORTANT: Are you enrolled in Medi-Cal? Compliance with these measures may reduce the need for you to send medical records later for review. 0000041623 00000 n CAHPSCAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 0000041110 00000 n trailer NCQA may terminate this Agreement at any time and without notice if Licensee violates any of the terms and conditions hereof. In addition, some sites may require you to agree to their terms of use and privacy policy. 0000043353 00000 n 0000004679 00000 n , II HEDIS is the measurement tool used by the nation s health plans to evaluate their performance in terms of clinical quality and customer service. 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? Quality measures help ensure our members receive appropriate care. The percentage of patients during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic 0000016961 00000 n 0000039848 00000 n 0000112852 00000 n 0000028427 00000 n 0000043549 00000 n H\n0E 0000037764 00000 n 0000041171 00000 n For the best experience on our site, be sure to turn on Javascript in your browser. Optima Preferred Provider Organization (PPO) products are issued and underwritten by Optima Health Insurance Company. hbbd```b`x"/I0yDHw`-R H2b;HWYH|&" 4H F ,{L `s?mm&F "3 0000011303 00000 n 0000040716 00000 n cytology performed between 2020-2022. 0000011749 00000 n hb```B ce`aB-G_PG 0000015935 00000 n Order educational materials for your patients. In January to May of 2023, data for 2022 continues to be submitted along with Medical Record review for Hybrid measures and final HEDIS 2022 rates and results are reported. HEDIS Measures A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. xref 0000006599 00000 n 0000029379 00000 n 0000038002 00000 n 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. Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 0000310045 00000 n 0000013210 00000 n Rate 2: Two additional well-child visits 15 to 30 months. 0000306723 00000 n 0000106009 00000 n 0000029610 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. 0000109341 00000 n 0000309690 00000 n For HEDIS related inquiries, please contact [email protected]. 0000013780 00000 n 0000033081 00000 n 0000040496 00000 n 0000313465 00000 n 7 e># v3jDZE#VLFPq3O "{B hs` p$}$gi}3.a Q[TjX Hb)UF0 ]nX3"W`XLi"0Lkc@JeH,6dTj&RXeQP_R%M0z/lTY\>T`*-8Y{VH_1j-9l$U61u~ju\t'vQ4sZJ.QsKIhQv\!W0$lOGG%r2/8=q smB9cve5vsAnU36 E{(f4OL`NY65U%mfu x.fxEy:f,*&_%7cSaAzATC G'QNXpk:@8S. 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). 0000309151 00000 n 0000004603 00000 n 0000009834 00000 n 0000039575 00000 n 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). HEDIS CHEAT SHEET 2022 - 2023 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents: Documented yearly for ages 3-17. 2127 0 obj <> endobj PRV 02.02.2022 . 0000042208 00000 n The obligations of both Parties shall not terminate upon any assignment or delegation attempted without such prior written consent. 0000016662 00000 n 0000013020 00000 n 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.
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