If any data is found in a supplemental data source, it is considered a supplemental data hit because the member would not be compliant for the measure/indicator without the data source.
HEDIS 2016
No. For HEDIS 2016 reporting, this new requirement was added to only the Effectiveness of Care (EOC) and EOC-like measures. “EOC-like measures” refers to the Utilization measures that have the same structure as and follow the same guidelines as the measures in the EOC domain (i.e., Frequency of Ongoing Prenatal Care, Well-Child Visits in the First 15 Months of Life, Well-Child visits in the Third, Fourth, Fifth and Sixth Years of Life, Adolescent Well-Care Visits). While supplemental data may be used for other measures, NCQA is not currently collecting this data element for other measures at this time.
HEDIS 2016
The reported rate calculation is the sum of all numerator events by administrative data, medical record data and supplemental data, divided by the eligible population for administrative measures, or by the denominator for hybrid measures (i.e., reported rate = numerator events by administrative data + numerator events by medical record data + numerator events by supplemental data / eligible population or denominator).
HEDIS 2016
Yes. The PCS system will be moved to a new Web site—http://my.ncqa.org—by the end of April. Customers who access the old PCS site will be automatically rerouted to the new site. The new site takes the same login and password; you will not need to change them.
HEDIS 2015
Yes. Starting in reporting year 2015, NCQA requires that all Licensed Organizations apply a password lock to the validated and approved sample frame file used for conducting the commercial and Medicaid Child and Adult CAHPS and the Qualified Health Plan (QHP) Enrollee surveys. Survey vendors may not pull a sample from an unlocked file.
HEDIS 2015
A version of the child survey that includes the CCC questions is part of HEDIS. If an organization uses the “With CCC” version of the questionnaire, the CCC items are considered part of the CAHPS 5.0H questionnaire and are not included in the count of 12 supplemental questions.
HEDIS 2015
There were mislabeled columns on three of tabs on the October 1 release: Volume 2 Value Sets to Codes; Summary of Changes—Codes; Summary of Changes—Value Sets. In all of these spreadsheets, the first column should be labeled “Value Set Name,” not “Measure ID.” This was corrected in the updated VSD released on 10/8/14. No changes were made to the value sets or codes.
HEDIS 2015
Organizations are not required to identify or confirm the diagnosis of diabetes through medical record review; only the hypertension diagnosis must be confirmed. Only administrative data should be used to assign the diabetes flag. The intent of the flag is to determine the appropriate BP threshold to use for the member during numerator assessment because the threshold for members with diabetes is different from the threshold for members without diabetes.
The only exception is if the member is flagged as a diabetic but medical record evidence contains information that classifies the member as a valid data error. To meet criteria as a valid data error, the medical record must contain no evidence of diabetes and include a notation that refutes the diagnosis, as described in Substituting Medical Records in the Guidelines for Calculations and Sampling. In this case, the diabetes flag may be changed to “not diabetic”, but the member may not be removed from the sample.
HEDIS 2015
Yes. In the Eligible Population section, replace the text in step 2 with the following: A member identified as having persistent asthma because of at least four asthma medication dispensing events, where leukotriene modifiers or antibody inhibitors were the sole asthma medication dispensed in that year, must also have at least one diagnosis of asthma (Asthma Value Set), in any setting, in the same year as the leukotriene modifier or antibody inhibitor (i.e., the measurement year or the year prior to the measurement year).
HEDIS 2015