PDF Guide to HEDIS Measures MY 2022 - L.A. Care Health Plan 0000005408 00000 n 0000024421 00000 n 0000307212 00000 n NCQA updated telehealth guidance in 40 HEDIS measures for HEDIS MYs 2020 and 2021. 0000012426 00000 n 0000019655 00000 n 0000004537 00000 n h_HSQ]B,7=$,h5%A9(4zoIdXYT The following activities are expressly prohibited in connection with the use of HEDIS Volume 2 under this Agreement: 1. HEDISThe Healthcare Effectiveness Data and Information Set (HEDIS) is a registered trademark of NCQA. Neither Party shall assign or otherwise delegate this Agreement or any rights, duties and/or obligations hereunder without the prior written consent of the other Party. 0000009879 00000 n Failure to insist on strict performance of any term of this Agreement will not operate as a waiver of any subsequent default or failure of performance. 0000042635 00000 n 0000308347 00000 n 0000033926 00000 n 0000042977 00000 n HEDIS 2022: Summary of changes from NCQA - Anthem z$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 0000042130 00000 n 0000013020 00000 n 0000038514 00000 n 0000004632 00000 n The License is limited subject to the following terms and conditions. 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. 0000026677 00000 n 0000040760 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. 8314 0 obj <>stream 0000042169 00000 n 0000033807 00000 n 0000041786 00000 n 2022. with: Progress note with latest blood pressure reading taken in . endobj 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. 0000039017 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"). 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. 0000036980 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. This new site may be offered by a vendor or an independent third party. 0000012472 00000 n 0000041742 00000 n %PDF-1.7 0000013361 00000 n Sole ownership rights to the Licensed Measure Specifications and any modifications, alterations or adjustments thereof reside with NCQA. 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. Individual HEDIS Measures Sheets | Providers | Optima Health 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. xn0#eR;TUj!@iFQ;6t$-h4Lblp|FC''p6@b^{|K@i&!MBot&ji`Wix P)V(K+Yn*g^\(5%ha 0000016961 00000 n 0000027717 00000 n 0000003724 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. HEDIS MY2022. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 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The percentage of patients during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. 0000108859 00000 n 0000307683 00000 n 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. 0000109048 00000 n L.A. 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Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health . 2022-2023 This guide provides HEDIS coding information only, not necessarily payment guidance. 0000032123 00000 n 0000011830 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. 0000052324 00000 n The License is not transferable from Licensee to any other person, entity, organization or association. 2022. 0000112852 00000 n Quality measures help ensure our members receive appropriate care. 0000309029 00000 n If a required measure has only Medicaid specifications, commercial organizations 0000015921 00000 n <]/Prev 525985/XRefStm 2956>> 0000002956 00000 n 1384 0 obj <>stream PDF HEDIS MY 2022 - Home | L.A. 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Helpful Hints Women 30-64 years of age who had cervical high-risk human papillomavirus (hrHPV) testing performed between 2018-2022. . 0000043946 00000 n 0000021024 00000 n What is HEDIS? 0000037990 00000 n %PDF-1.6 % 0000010426 00000 n 1111 61 0 PDF Health Net - Coverage for Every Stage of Life | Health Net Compliance with these measures may reduce the need for you to send medical records later for review. / 0000009093 00000 n Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the Agreement terms below. Make sure your medical records reflect the following:-A note indicating a visit to PCP More than 90 percent of America's health plans use HEDIS to evaluate performance. A Licensed User must be using HEDIS Volume 2 under the License and solely on behalf of the Licensee. 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. 0000043814 00000 n HEDIS | Blue Cross and Blue Shield of Illinois - BCBSIL 4 0 obj Read more about the HEDIS schedule changehere. !N8X efI~wh73Q>oVZ+ cmG!gV?ngR~7rUCZEOA`3t= pO] Vv 5wq26mxvBh. endstream endobj startxref xref JavaScript seems to be disabled in your browser. Adults' Access to Preventive/Ambulatory Health Services (AAP) Description; Assesses the percentage of members 20 years and older who had an ambulatory or preventive care visit during the measurement year . PDF 2021-2022 HEDIS and VBP TIP Sheet - Maryland Physicians Care 0000008785 00000 n 0000010465 00000 n PDF Hedis Cheat Sheet 2022 - 2023 For the best experience on our site, be sure to turn on Javascript in your browser. 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. Documentation in a standardized prenatal flow sheet, or; b. 0000306723 00000 n Health Net - Coverage for Every Stage of Life | Health Net 0000006654 00000 n 0000002775 00000 n 0000000016 00000 n 0000042331 00000 n LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF HEDIS VOLUME 2. 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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 PDF HEDIS Toolkit for Providers Measurement Year 2023 - Aetna Licensee agrees to maintain HEDIS Volume 2 in strict confidence and abide by all terms and conditions of this Agreement. 0000044201 00000 n 0000029379 00000 n Optima Health 2023, 4417 Corporation Lane, Virginia Beach, VA 23462-3162. 0000312745 00000 n 0000310217 00000 n Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 0000009862 00000 n PDF 2022 Hedis (Measurement Year) Medicaid Reference Sheet Telehealth encounters in . 0000072229 00000 n 2022. 0000310823 00000 n 0000037577 00000 n 0000037764 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. 0000013091 00000 n 0000033255 00000 n PDF HEDIS 2022 Manual - Johns Hopkins Medicine 0000040859 00000 n %%EOF 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. 0000010484 00000 n 0000003174 00000 n 0000041005 00000 n PDF 2022 MEDICAID HEDIS REFERENCE SHEET FOR PROVIDERS - Molina Healthcare 0000042208 00000 n The section headings contained in this Agreement are included for reference only and shall not affect the construction or interpretation of any term in this Agreement. hb```b``e`c` @1v %M0-en{B)"p.1*'Y>Me}E;)2&u_hvO4Wu)4/Q%fV![\AE:-Trdc 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. 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. 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. 0000012711 00000 n 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. In addition, some sites may require you to agree to their terms of use and privacy policy. New HEDIS Measures for MY 2023 HEDIS Measure Descriptions Frequently Asked Questions CLINICAL REFERENCE Avoidance of Antibiotic Use Clinical Guidelines HEDIS Measures Immunization Schedules 0000109736 00000 n The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. 0000002209 00000 n H@z Pk4wXvTxv 0000006410 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 L.A. Care rewards high performing physicians for providing quality care to our members. 0000033138 00000 n PDF HEDIS Quick Reference Guide - Health Net 0000004280 00000 n endstream endobj startxref 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. BP taken and reported by member using . 0000028427 00000 n NCQA has recommended 5 HEDIS measures be included beginning MY2022 with expectations to expand across a minimum of 15 measures by MY2024. 0 0000023670 00000 n 0000312555 00000 n 0 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. <> 0000009376 00000 n Except as expressly authorized or provided for herein, Licensee shall: (i) only adjust the Licensed Measure Specifications, or any portion thereof, as permitted by the Rules;(ii) not delete or in any manner alter any notices, disclaimers or other legends contained in HEDIS Volume 2 or appearing on any screens, documents or other materials obtained through use of HEDIS Volume 2;(iii) prominently display language as displayed in Section 17 when adjusting the Licensed Measure Specifications as permitted by the Rules; (iv) not use HEDIS Volume 2 (including the Licensed Measure Specifications) or any portion thereof for any purpose other than as specifically set forth in this Agreement;(v) not publicly display, disseminate or publish the HEDIS Volume 2 (including the Licensed Measure Specifications), modifications or adjustments thereof or any portion of the same;(vi) not use the HEDIS VSD or any portion thereof without an authorized license from the copyright owners; (vii) not provide service bureau facilities or commercial time-sharing services to any third party or supporting operations for any third party through access and/or use of HEDIS Volume 2;(viii) not transmit HEDSI Volume 2 electronically or allow access to HEDIS Volume 2 over a network or a public computer-based information system which permits access to a greater number of users than licensed by Licensee; (ix) not authorize or permit any third-party or affiliate, subsidiary or related entity to use HEDIS Volume 2 (including the Licensed Measure Specifications) or any portion thereof without NCQA's prior written consent;(x) not identify records or calculate or display any calculated measurement (HEDIS measure result) stemming from the Licensed Measure Specifications;(xi) not reproduce, copy, reverse engineer, decompile or disassemble the Licensed Measure Specifications or prepare derivative works from the Licensed Measure Specifications or any portion thereof t (except that Licensee may make one [1] copy for each Licensed User for which Licensee has purchased a license to use HEDIS Volume 2); and(xii) not ship, transmit, transfer or export Volume 2 (including the Licensed Measure Specifications) or any portion thereof outside of the U.S. or to clients or other end-users primarily located outside of the U.S. 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. 0000039848 00000 n An organizations licensed users may use the materials solely for an internal non-commercial purpose without obtaining NCQA approval. 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: 0000041082 00000 n HEDIS Measurements - Aetna 0000307059 00000 n 0000039575 00000 n Help your patients with redetermination. Except where noted, the tip sheets include measure requirementsfor all our members including,all fully-insured PPO, Blue Choice PPOSMand HMO, Blue Cross Community Health PlansSM(BCCHPSM), Blue Cross Community MMAI (Medicare-Medicaid Plan)SMand Medicare Advantage members(unless otherwise specified). 0000034689 00000 n digital device in . 0000041623 00000 n View Table of Contents for this Publication. T 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) A dated graphic sheet . PDF HEDIS VOLUME 2 MY 2022 - National Committee for Quality Assurance 0000017908 00000 n Order educational materials for your patients. Note:NCQA has updated the naming convention of HEDIS publications to refer to the measurement year (MY) for HEDIS measures. 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). 0000014908 00000 n 0000033702 00000 n 0000010194 00000 n View our frequently asked questions. 0000019374 00000 n 0000022782 00000 n 7nuT.,qUN^UNws}a9z6^.WU'_, rQTULzX{3yq\9$`IKz128~LVPwZZ8/8}W6!e2=M!\K!;.^)`'>F=D;D5L>5PfOTx) 0000042845 00000 n any. 0000042375 00000 n 1371 0 obj <>/Filter/FlateDecode/ID[<7F9DDD8800BFEE4C9404AE52E016A647><02E18FF8926EFD40AEA58E0129A180D3>]/Index[1349 36]/Info 1348 0 R/Length 110/Prev 309529/Root 1350 0 R/Size 1385/Type/XRef/W[1 3 1]>>stream 0000033025 00000 n 0000040259 00000 n To verify compliance with this Agreement, NCQA is granted the right, with prior notice and during normal business hours, to examine all relevant records of Licensee. 0000004105 00000 n 0000029485 00000 n fz4cFb'98}1m'Gv{YMvEH_Wma}hn'a^`lwZwRis-^sQF6'[ZR)kH6fW=gpO'/ n &a)^y`_O~~$H67XIkxz}qk7^UXYlP!Fc#jxw!W(E_4CvF4DnL))Tz2R8./SiV5,hKkO(|Q_Y{IWYj&Yp\2/3%XhWtt0E{At5n6E'>loT%/$[s7 ]c9~G 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. 0000040184 00000 n 0000018194 00000 n stream The National Committee for Quality Assurance (NCQA) has changed, revised, and retired HEDIS for measurement year 2022. 0000044076 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. NCQA and Licensee may be individually referred to as a Party, or collective, the Parties. The National Committee for Quality Assurance (NCQA) developed the HEDIS measures. 0000042542 00000 n 0000039652 00000 n 0000307846 00000 n 2127 87 H\n0E PDF HEDIS Provider Pocket Guide - Molina Healthcare 0000041544 00000 n NCQA Proposed Measure Changes for HEDIS 2022 - Ciox 0000028129 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) 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. 0000002081 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. 58 61 2021-2022 HEDIS and VBP TIP Sheet . HEDIS Resources | L.A. Care Health Plan 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. 1407 0 obj <> endobj 0000108933 00000 n 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. i09}}y P 5 0000034562 00000 n 0000004991 00000 n Updates on HEDIS Measures MY2022 . 0000009238 00000 n THE USE OF THE LICENSED MEASURE SPECIFICATIONS IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. 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. 0000312918 00000 n Commercial specifications should be followed for all required HEDIS 2022 and QARR 2022 NYS-specific measures. 0000036108 00000 n L.A. Care is proud to participate in Covered California to offer affordable health insurance to Los Angeles County residents. HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . 0000038453 00000 n 0000039528 00000 n The obligations of both Parties shall not terminate upon any assignment or delegation attempted without such prior written consent.