Yes. Documentation of “Colon Screening,” “Colon Screen” or “Colorectal Cancer Screening,” with screening dates during the measurement year, could indicate an FOBT, the least invasive test that would use this limited documentation.
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2.15.2024 Indication of an FOBT Test for the Colorectal Cancer Screening Measure Is documentation of “Colon Screening,” “Colon Screen” or “Colorectal Cancer Screening” sufficient to be considered an FOBT if it was completed during the measurement year?
2.15.2024 Compliant Documentation of Colonoscopy for the Colorectal Cancer Screening Measure Is documentation of “c-scope," “colo” or “colon” sufficient to be considered a colonoscopy?
2.15.2024 Use of Continuity of Care Documents (CCDs) Can CCDs from health information exchanges be used for medical record review?
No. The medical record review process for the hybrid data collection methodology requires that information be abstracted from the medical record. CCDs are not the same as the medical record; this includes CCDs received from health information exchanges. Note that because electronically exchanged CCDs may be used as supplemental data, they are subject to supplemental data requirements.
This applies to the following Programs and Years:
HEDIS MY 2023, 20242.15.2024 Provider Interaction with Admission/Discharge Information in the Medical Record for the Transitions of Care Measure For the Notification of Inpatient Admission and Receipt of Discharge Information indicators, is evidence that the provider reviewed the admission/discharge information required (i.e., is the provider required to sign or acknowledge the admission/discharge information after it is filed in the outpatient medical record)?
No. Evidence that the PCP or ongoing care provider reviewed the admission/discharge information is not required for these indicators. If the required information is filed in the outpatient medical record or shared EMR (accessible to the PCP or ongoing care provider) during the required time frame, this alone meets criteria.
This applies to the following Programs and Years:
HEDIS MY 2023, 20242.15.2024 ADT Feeds for the Transitions of Care Measure Does an admission notification documented in an ADT feed meet criteria for the Notification of Inpatient Admission and Receipt of Discharge Information indicators?
No. Admission/discharge notifications in the ADT alone do not meet criteria (even if the provider has access to the ADT) because ADTs are not considered the legal medical record.
Criteria are met if the provider documents ADT notifications in the appropriate outpatient medical record or shared EMR (accessible to the PCP or ongoing care provider) during the time frame specified in the measure.
This applies to the following Programs and Years:
HEDIS MY 2023, 20242.15.2024 FI-SNPs, HI-SNPs, IE-SNPs and HEDIS Reporting Are Facility-Based Institutional SNPs (FI-SNPs), Hybrid Institutional SNPs (HI-SNPs) and Institutional Equivalent-SNPs (IE-SNPs) treated the same as I-SNPs when reporting HEDIS?
2.01.2024 Health Plan Ratings Sites Login (Plan Confirmation, Projected Ratings, Final Ratings) Why can’t I log on to Plan Confirmation/Projected Ratings/Final Ratings? Or I can log on, but I don’t see any plans?
2.01.2024 Health Plan Ratings Historical Data Where can I access prior year HPR scores or retrospective HPR data?
NCQA currently maintains prior year HPR scores here: https://reviewratingsfinal.ncqa.org. You can also purchase the HPR detailed results file which lists plan’s overall rating, composite, subcomposite and measure level scores: https://store.ncqa.org/other-products/health-plan-rankings.html
This applies to the following Programs and Years:
2.01.2024 Health Plan Ratings Exchange Plans Why don’t I see my Exchange plan in Health Plan Ratings?
NCQA currently does not rate Exchange plans for Health Plan Ratings/Health Plan Accreditation (HPR/HPA). This is primarily because CMS has their own Quality Rating System (QRS), and NCQA has to receive special permission from CMS to use the data for our Accreditation program. NCQA is actively participating in these discussions, and any changes to this policy will be communicated to all organizations in a timely manner.
This applies to the following Programs and Years:
2.01.2024 Health Plan Ratings State Coverage How does NCQA define “state coverage”?
NCQA defines “state coverage” as the states where a plan is licensed to operate. Plans that submit HEDIS/CAHPS data provide this information each year during the HOQ process. If plans do not submit these data, NCQA uses state licensing and membership data provided for Accreditation or gathered from external sources.
This applies to the following Programs and Years:
1.16.2024 3-Dose-Series Prevnar 20 Pneumococcal Vaccine for Childhood Immunization Status (CIS) When will PCV20 pneumococcal vaccine be added to the pneumococcal conjugate value sets?
We anticipate that PCV20 will be added to the CIS value sets in the HEDIS MY 2024 Technical Update, scheduled for release on April 1, 2024.
Although the PCV20 vaccine is not included in the measure for MY 2023, NCQA does not anticipate this will impact performance. The measure denominator only includes children who were at least 18 months old and expected to have already completed the pneumococcal series by June 2023 (the month when ACIP recommended PCV20).
This applies to the following Programs and Years:
HEDIS MY 2023, 202412.15.2023 Updated CR Accreditation Eligibility and Reportable Events The 2024 CR Accreditation standards allow organizations that delegate more than 50% of primary source verifications to be eligible for Credentialing Accreditation, as long as all delegates have NCQA Credentialing Accreditation or NCQA Credentialing/CVO Certification. What happens if a delegate loses Accreditation/Certification status after the organization’s survey?
If an organization delegates more than 50% of primary source verifications and one or more of its delegates loses Accreditation/Certification status, NCQA considers this a Reportable Event. The organization must notify NCQA (through My.NCQA.org) within 30 calendar days.