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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. 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. 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 0000092876 00000 n
New HEDIS Measures for MY 2023 HEDIS Measure Descriptions Frequently Asked Questions CLINICAL REFERENCE Avoidance of Antibiotic Use Clinical Guidelines HEDIS Measures Immunization Schedules 0000312102 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. 0000109341 00000 n
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Rate 1: Six or more well-child visits* 0 to 15 months. 2022. 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. 0000032123 00000 n
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The HEDIS VSD is made available for customers that purchase a license for HEDIS Volume 2 from NCQA. 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 . xref
Note:NCQA has updated the naming convention of HEDIS publications to refer to the measurement year (MY) for HEDIS measures. 0000040760 00000 n
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For example, 2022 claims, encounters, and other HEDIS data are submitted throughout 2022. 0000004603 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. 0000092606 00000 n
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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). 0000012573 00000 n
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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. Make sure your medical records reflect the following:-A note indicating a visit to PCP 0000041331 00000 n
Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. 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). Refer your patients for Health Education Services. 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. 0000041786 00000 n
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The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 0000015935 00000 n
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2021-2022 HEDIS and VBP TIP Sheet . L.A. Care rewards high performing physicians for providing quality care to our members. The License is not transferable from Licensee to any other person, entity, organization or association. 0000034181 00000 n
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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. 0000042130 00000 n
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THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF HEDIS VOLUME 2 IS WITH THE LICENSEE. An organizations licensed users may use the materials solely for an internal non-commercial purpose without obtaining NCQA approval. Have you tried MyHIM, our member wellness program?
Refer to your state's guidance for payment details and telehealth regulations. SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES . 0000002956 00000 n
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cytology performed between 2020-2022. 0000042498 00000 n
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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. Sole ownership rights to the Licensed Measure Specifications and any modifications, alterations or adjustments thereof reside with NCQA. 0000093172 00000 n
Blue Cross and Blue Shield of Illinois (BCBSIL) reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results. 0000040337 00000 n
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Rate 2: Two additional well-child visits 15 to 30 months. 0000005173 00000 n
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.
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A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. <]/Prev 961931/XRefStm 4105>>
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. 0000309690 00000 n
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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. Submit this inquiry by logging intoMy NCQA, selecting theAsk a Questionbutton, then theOrdersbutton, then theCustom License Requestsoption.
It also includes general guidelines for data collection and reporting, detailed instructions about how to perform the necessary calculations and guidelines for sampling. 0000022547 00000 n
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Order educational materials for your patients. 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. 0000032765 00000 n
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Commercial specifications should be followed for all required HEDIS 2022 and QARR 2022 NYS-specific measures. 0000042169 00000 n
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What is HEDIS HEDIS rates are the most widely used set of health care performance measures on important preventive and clinical services. 0000043593 00000 n
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NCQA updated telehealth guidance in 40 HEDIS measures for HEDIS MYs 2020 and 2021. 0000034175 00000 n
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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. 0000313465 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. endstream
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HEDIS MY 2022 . The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. For the best experience on our site, be sure to turn on Javascript in your browser. Molina Healthcare of California participates in HEDISas part of our State quality reporting 0000013780 00000 n
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NCQA and Licensee may be individually referred to as a Party, or collective, the Parties. 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. What is HEDIS? 0000033255 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. 0000031901 00000 n
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Upon termination of this Agreement, all rights under this Agreement, including the License, will cease. 0000310045 00000 n
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LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF HEDIS VOLUME 2. For the best experience on our site, be sure to turn on Javascript in your browser. 0000023670 00000 n
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HEDIS Measures A quick and easy reference containing the most current information, measure descriptions, and tips to help improve rates of compliance. 0000108743 00000 n
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The adjusted measure specification may be used only for internal quality improvement purposes. The clinical information provided is intended to aid in the understanding of HEDIS measures. HEDISThe Healthcare Effectiveness Data and Information Set (HEDIS) is a registered trademark of NCQA. oaoNNg. As a result, HEDIS is the ultimate measurable tool to evaluate provider's performance and quality of care. 0000013020 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. 0000135675 00000 n
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In addition, some sites may require you to agree to their terms of use and privacy policy. 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. HEDIS Volume 2 is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. HEDIS MY 2022 Measures Applicable to: Commercial Medicaid Medicare Changes for HEDIS MY 2022 General Guidelines for Data Collection and Reporting 0000009376 00000 n
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2022. 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. %%EOF
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. 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. 0000038593 00000 n
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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).
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