The Hemoglobin A1c Control for Patients With Diabetes measure should be removed from the measure list. The Plan All-Cause Readmissions measure should be added to the list. This clarification will be in the MY 2023 Technical Update.
HEDIS 2023
FAQ Directory
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9.15.2022 General Guideline 32: Medicare Socioeconomic Status Stratification Which measures does General Guideline 32: Medicare Socioeconomic Status Stratification apply to?
9.15.2022 Social Need Screening and Intervention (SNS-E) For SNS-E, are organizations allowed to count screenings that were conducted using adapted or translated versions of screening instruments?
As an ECDS-reported measure, the SNS-E screening numerator counts only screenings that use instruments in the measure specification as identified by the associated LOINC code(s). Allowed screening instruments and LOINC codes for each social need domain are listed in “Definitions” in the measure specification.
NCQA recognizes that organizations might need to adapt or modify instruments to meet the needs of their membership. To clarify:
- The SNS-E measure specification does not prohibit cultural adaptations or linguistic translations from being counted toward the measure’s screening numerators.
- Only screenings documented using the LOINC codes specified in the SNS-E measure count toward the measure’s screening numerators.
- The Regenstrief Institute, which maintains the LOINC database, has indicated that LOINC codes do not distinguish between adapted and translated instruments.
- Tool developers have varying policies with regard to cultural adaptation and translations; some state that users may adapt screening instruments, others state that organizations must obtain permission first.
NCQA urges organizations to refer to the tool developer for information about adaptations or translations that are available or allowed.
HEDIS 2023
9.15.2022 Race/Ethnicity Diversity of Membership (RDM) The RDM measure references General Guideline 31: Race and Ethnicity Stratification, but the MY 2023 Value Set Directory does not list race/ethnicity value sets or direct reference codes. Are these used when reporting the RDM measure?
9.15.2022 Follow-Up Care for Children Prescribed ADHD Medication (ADD) In step 1 of the Event/Diagnosis for Rate 1, what timeframe is used to identify dispensed ADHD medications?
9.15.2022 Durable medical equipment in the scope of credentialing Are durable medical equipment entities in the scope of credentialing?
Yes. Durable medical equipment entities are in the scope of CR 7, Element A, to the extent that organizations must have policies and procedures for initial and ongoing assessment of the entities with which it contracts. NCQA’s review of the organization’s assessment of organizational providers is limited to the organizations listed in CR 7, Elements B and C.
HP 2022
9.15.2022 MBHO: File Review Scope for NCQA-Accredited MBHOs seeking UM-CR-PN Accreditation How many files are reviewed in a UM-CR-PN Survey for Accredited MBHOs?
9.15.2022 Antibiotic Utilization for Respiratory Conditions (AXR) The Antibiotic Utilization for Respiratory Conditions (AXR) does not include age stratifications and total rate bullets. Was this intentional?
No. A correction will be in the MY 2023 Technical Update. The Ages section in the Eligible Population should read as follows:
Members who were 3 months of age or older as of the Episode Date. Report three age stratifications and a total rate:
- 3 months–17 years.
- 18–64 years.
- 65 years and older.
- Total.
The total is the sum of the age stratifications.
HEDIS 2023
9.15.2022 Oral Evaluation, Dental Services (OED) The OED measure references the NUCC Provider Taxonomy Value Set to identify dental providers. Is this correct?
9.15.2022 Backdating effective dates Can an organization backdate an effective date for a practitioner to the practitioner’s start date in the network?
9.15.2022 PCS Questions Do answers from the Policy Clarification Support system have an expiration date?
9.15.2022 Quality Compass Appearance Prior to Purchasing How can I see what Quality Compass looks like prior to purchase?
You can experience Quality Compass’ functionality by watching the demo videos available on the Quality Compass webpage (https://www.ncqa.org/programs/data-and-information-technology/data-purchase-and-licensing/quality-compass/). The demo videos walks viewers through some of the key features of Quality Compass as well as how to navigate the tool.
You can also request a walk-through live demo from the Information Products team. Please submit your request through your my.NCQA.org account or contact NCQA’s Customer Support team.
HEDIS 2022
9.15.2022 Quality Compass Sharing Restrictions What are the sharing restrictions and guidelines for distributing the data available on Quality Compass?
You can find the standard guidelines and restrictions for data usage in Section 2 of the Quality Compass license agreement. This agreement in located on our website as well as on the NCQA store site, prior to any purchase of a license. If you expect your data usage to fall outside of the permissions set forth in the standard agreement, NCQA offers customized agreements to grant extended permissions and use cases, subject to a separate fee.
If you are unsure if your use case falls outside the standard license terms, submit your question via my.ncqa.org for further assistance.
HEDIS 2021