FAQ Directory: Long-Term Services and Supports Distinction for Health Plans

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10.15.2024 Eligibility for NA for QI 3 My organization did not receive a Health Plan Rating (HPR) scoresheet. How will my organization be scored in QI 3 for a Renewal Survey?

For commercial, Medicare and Medicaid organizations to be able to calculate an average rating for QI 3, Element B, they must receive a Health Plan Ratings scoresheet. Only organizations that have complete data receive a rating and scoresheet. Therefore, organizations that do not receive an HPR scoresheet will be scored NA in QI 3, Elements B and C. 

The organization must demonstrate that it meets the requirements in QI 3, Element A, and will not be eligible for NA for that element.

Similarly, if an Exchange organization either does not report QRS data to CMS or receives NR for the Exchange product line because it does not have a valid rate for any required QRS measure in Element D, it must demonstrate data exchange in QI 3, Element A.   

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