%%EOF 0000003724 00000 n 2 0 obj 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. 0000041742 00000 n Individual HEDIS Measures Sheets | Providers | Optima Health CAHPSCAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). 0000036187 00000 n HEDIS Tip Sheets | Blue Cross and Blue Shield of Illinois - BCBSIL 0000016645 00000 n PDF Quick Reference Guide HEDIS MY 2023 [ 0000010426 00000 n 0000028427 00000 n 0000307344 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. 0000040496 00000 n 0000033025 00000 n <<3742E41188BCC64D926D69F1B7DDE543>]/Prev 282268/XRefStm 4469>> 58 61 0000034175 00000 n NCQA Proposed Measure Changes for HEDIS 2022 - Ciox 0000013020 00000 n vtt4LJ0G4v@uE %%aP=PKhXZ`ZZZF&m sq/P"]@ 1.2 Marks means the NCQA trademarks and/or service marks related to the Licensed Measure Specifications described in Section 5. A Licensed User may not be an agent or consultant of a Licensee. 0000020709 00000 n 0000044201 00000 n 0000108677 00000 n 0000012285 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. 1384 0 obj <>stream o,;6iN?e/.y)>2-@%!H20C@eW D* G^ Updates on HEDIS Measures MY2022 . 11. 0000308484 00000 n 0000042055 00000 n 0000004308 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. 0000042375 00000 n Controlling High Blood 18 - 85 yrs. 0000007509 00000 n PDF HEDIS MY 2022 - Home | L.A. Care Health Plan To view this file, you may need to install a PDF reader program. Have you tried MyHIM, our member wellness program? T If a required measure has only Medicaid specifications, commercial organizations Most PDF readers are a free download. 0000004603 00000 n 0000010761 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. View our frequently asked questions. 0000042889 00000 n 7nuT.,qUN^UNws}a9z6^.WU'_, rQTULzX{3yq\9$`IKz128~LVPwZZ8/8}W6!e2=M!\K!;.^)`'>F=D;D5L>5PfOTx) Make sure your medical records reflect the following:-A note indicating a visit to PCP HL7 is the registered trademark of Health Level Seven International. trailer 0000308649 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. 0000012573 00000 n 0000307212 00000 n 0000003478 00000 n Follow HEDIS 2022 instructions regarding commercial POS products. 2022. 8259 0 obj <> endobj 0000042977 00000 n 0000012813 00000 n Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. HEDIS Measurement Year (MY) 2023 Provider Tips for Optimizing HEDIS 0000106048 00000 n JavaScript seems to be disabled in your browser. 0000006919 00000 n 0000006654 00000 n 0000023321 00000 n 0000015577 00000 n 2022. with: Progress note with latest blood pressure reading taken in . The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. The report cards use a standard set of measures called the Healthcare Effectiveness Data and Information Set (HEDIS ).*. 0000003432 00000 n 0000034332 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). 0000013372 00000 n 0000040859 00000 n x\B+C8 ssVj'. HEDIS/CAHPS Measures Required for HP AccreditationCommercial *The weight column indicates the weight of the item (maximum value = 3) in the overall score calculation. 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. Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the Agreement terms below. 0000041171 00000 n 0000042845 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 1. 0000011425 00000 n 0000006410 00000 n 1111 61 / 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). %PDF-1.6 % Licensee agrees to maintain HEDIS Volume 2 in strict confidence and abide by all terms and conditions of this Agreement. 0000310525 00000 n 1407 121 0000043946 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) 1527 0 obj <>stream hbbd```b`` @$SdId:lZ ] DHV~'l g" 1D]3@{@Wn``W ! 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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. 0000011894 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. 0000022901 00000 n 0000012368 00000 n trailer 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). 0000041005 00000 n HEDIS | Blue Cross and Blue Shield of Illinois - BCBSIL 0000004632 00000 n 0000307514 00000 n 0000043593 00000 n % 0000042130 00000 n Have questions about renewing your Medi-Cal? The clinical information provided is intended to aid in the understanding of HEDIS measures. Rate 2: Two additional well-child visits 15 to 30 months. 0000043052 00000 n PDF 2020 HEDIS Cheat Sheet - irp-cdn.multiscreensite.com 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. 0000040259 00000 n 0000308812 00000 n Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 0000012711 00000 n 0000004718 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. %%EOF or. 0000032765 00000 n 0000009121 00000 n 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. 0000017945 00000 n Upon termination of this Agreement, all rights under this Agreement, including the License, will cease. 0000012426 00000 n 0000032558 00000 n 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. Rate 1: Six or more well-child visits* 0 to 15 months. Licensee may not allow a third party to view or use HEDIS Volume 2. 0000004105 00000 n trailer Any 0000016662 00000 n 0000029485 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). Help your patients with redetermination. endstream endobj startxref HEDIS MY 2022, Volume 2 HEDIS VOLUME 2 MY 2022 . 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. %%EOF 0000010194 00000 n endobj An organizations licensed users may use the materials solely for an internal non-commercial purpose without obtaining NCQA approval. 0000044158 00000 n 0000042661 00000 n 0000029168 00000 n 0000108859 00000 n Unauthorized internal distribution of the publication and materials thereinbeyond the number of users licensed by your organizationis prohibited. 0000036980 00000 n 0 Documentation of LMP, EDD or gestational age, or 0000041623 00000 n Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results. 0000034483 00000 n TO THE MAXIMUM EXTENT ALLOWABLE BY LAW, THE PARTIES DISCLAIM THE APPLICABILITY OF THE UNIFORM COMMERCIAL CODE OR OTHER UNIFORM LAWS. As a result, HEDIS is the ultimate measurable tool to evaluate provider's performance and quality of care. 0000135675 00000 n 0000033255 00000 n 0000031213 00000 n 0000309339 00000 n 0000034689 00000 n The percentage of patients during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic 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. hV PSW}I~B!i `!VDEeSpIQEF-@YBUDm_tw&s9 @@8 @L.i f,2e#/]DHVjI41;k!hM'% ALqnEyWyyrR}w05(Z2|D 0000002775 00000 n 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. NCQA and Licensee may be individually referred to as a Party, or collective, the Parties. endstream endobj 2212 0 obj <>/Filter/FlateDecode/Index[119 2008]/Length 63/Size 2127/Type/XRef/W[1 1 1]>>stream 0000109736 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. If any portion of this Agreement is determined by a court of competent jurisdiction or any appropriate legislature or governmental agency to be wholly or partially unenforceable, for any reason, such term shall be deemed to be modified to the minimum extent necessary to comply with such law, ruling or regulation, and the remainder of this Agreement shall not be affected thereby. L.A. Care is proud to participate in Covered California to offer affordable health insurance to Los Angeles County residents. 0000032123 00000 n 0000037913 00000 n PDF HEDIS Provider Pocket Guide - Molina Healthcare 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. 0000043726 00000 n 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. 0000043472 00000 n 0000019994 00000 n 0000041110 00000 n 0000033081 00000 n Sentara Health Plans, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. The following sections shall survive termination of this Agreement: Sections 2, 6, 7, 8, 9, 10, 11, 12 and 18. 0000041066 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. IMPORTANT: Are you enrolled in Medi-Cal? 0000041498 00000 n Compliance with these measures may reduce the need for you to send medical records later for review. 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. 0000043309 00000 n This new site may be offered by a vendor or an independent third party. 0000041331 00000 n NCQA > HEDIS MY 2022 Volume 2 (epub) 0000052324 00000 n endstream endobj startxref 0000012545 00000 n For example, 2022 claims, encounters, and other HEDIS data are submitted throughout 2022. The National Committee for Quality Assurance (NCQA) has changed, revised, and retired HEDIS for measurement year 2022. PDF HEDIS 2022 Manual - Johns Hopkins Medicine 0000037498 00000 n 0000001516 00000 n 0000041621 00000 n rates. 0000014342 00000 n THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF HEDIS VOLUME 2 IS WITH THE LICENSEE. 0000009376 00000 n 0000012694 00000 n hbbd```b`x"/I0yDHw`-R H2b;HWYH|&" 4H F ,{L `s?mm&F "3 0000032166 00000 n digital device in . Copyright 2023 National Committee for Quality Assurance. Prohibited Use AcknowledgementAn organizations Licensed Users may use HEDIS Volume 2 solely for a personal non-commercial purpose without obtaining NCQA approval. 0000022782 00000 n 0000034181 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). %PDF-1.5 % Read more about the HEDIS schedule changehere. 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. 0000007580 00000 n 0000308347 00000 n HEDIS Volume 2 is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. 0000311932 00000 n PDF Health Net - Coverage for Every Stage of Life | Health Net Billing Reference Sheets and Claims Submission and Guidelines, Pediatric Obesity Prevention and Treatment Toolkit. 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 0000043265 00000 n Compliance with these measures may reduce the need for you to send medical records later for review. 0000021645 00000 n 0000092876 00000 n 0000005408 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. 1111 0 obj <> endobj No amendment, other modification or waiver of any term of this Agreement will be valid unless in writing signed by both parties. :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* %PDF-1.6 % 0000033334 00000 n Anyone desiring broader internal distribution of HEDIS Volume 2 must purchase additional Licensed User permissions via the NCQA Store. 0000040184 00000 n PDF 2021-2022 HEDIS and VBP TIP Sheet - Maryland Physicians Care Sign up for or check out past quality improvement webinars on topics ranging from diabetes care to data submission. 0000014698 00000 n Molina Healthcare of California participates in HEDISas part of our State quality reporting 0000043902 00000 n 0000043182 00000 n MEASUREDESCRIPTION OF MEASUREDOCUMENTATION TIPSCOMPLIANCE CODES & MEASURE TIPS Prevention and Screening Cervical Cancer Screening (CCS)* 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. 0000307059 00000 n xref , II The License is limited subject to the following terms and conditions.
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hedis 2022 cheat sheet