Heres how you know. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Focus areas to ensure high quality. %PDF-1.5 % Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. or Licensee may need additional software to use the Product, and NCQA is not responsible for such additional software. hbbd```b``~"R [UuKo-3q/pEqx".z+EX,?+"'MNb)=)V+QK,gK!^}@]^,\J N8AB[0|7x MbN_M9[1g05KL :7f>~C|Vp$'*.ljYZ\l:ZS|s{No#mi',tg,j>0~Y=%B-}xi(~ hA_wfsb { lock Eligibility requirements, application information and policies and procedures are included as well. X. SeverabilityIf any portion of this License Agreement is determined by a court of competent jurisdiction or any appropriate legislature to be wholly or partially unenforceable, for any reason, such unenforceability shall not affect the balance hereof. Appropriate client agreements and collaboration. Sign up to get the latest information about your choice of CMS topics. endstream endobj startxref The Product is being licensed (not sold) to you, the Licensee (the License). Governing Law and General ProvisionsThis License Agreement shall be governed and construed in accordance with the laws of the District of Columbia without regard to its choice of laws. Organizations must meet program criteria to pursue this accreditation. This Publication License Agreement, along with all materials referenced herein ("License Agreement"), is a legal agreement between the individual or entity purchasing the license to use the Product (hereinafter the Licensee) and the National Committee for Quality Assurance (NCQA). 3 0 obj NCQA > 2022 Standards and Guidelines for the Accreditation of Health Plans (epub) 2022 HP Standards and Guidelines (epub) Number Of Users Single User: $410.00 2-4 Users: $1,150.00 5-10 Users: $2,670.00 11-20 Users: $4,920.00 21-30 Users: $7,380.00 31-50 Users: $12,300.00 NCQA PUBLICATION LICENSE AGREEMENT Licensee may need additional software to use the Product, and NCQA is not responsible for such additional software. Share this page with a friend or colleague by Email. An organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. means youve safely connected to the .gov website. The timing is flexible and up to the practice to determine. h{koG_G X4!iIZHm*)yn`Pxq|f-gZ3^IU\E,V/pfs-Qjl2j %X2c>>/i1f2<5GBghj,em@?}as_o.]~wTv]p>]{w?/&F~tZyF0}#?mVononW?72PwglMU8:2_vT~wi?sv/ r[7VjQ^x|;X77nM|"zyu,pq?$Wg+[}ry$x?~6-n~]ts~V1Ww?\mvJBS |{i{sV~ ,'|^]+:Y>R>}/Z (m`3.bL,@VE~21"dm([P `[y~qx>*S:`iV81~RO/O.0] }x^P#rbriy+#B8},-5%(muE}wuk#;3#}?OyLrm4|8:p:w~|f:Nmr{G\x(]`u{^cU,N]v5L;FK/WD\oX{*9)Pb,Y%'8:VWD endstream endobj 90 0 obj <> endobj 91 0 obj <> endobj 92 0 obj <>stream ,xbcb({h`>0-810d|2?k=7_u>7o6'U BnvzEe/. =rtlh.ew\^7GqsUbefrNd@yE\z1{#~vlVV>8;"s%!KQP8v %EXe dRq[aq`$p0b2d&Fdmm0QfEJIz}33*g-yQV6hN}xmQHYBvF*.hvmrm40g4h2f Upon accessing the Product, the Licensee is deemed to have accepted the license subject to the terms and conditions of this License Agreement. See our. 59CNByOzdm NCQA does not within the standards of our HIPAA Nothing included in NCQA standards are intended to conflict with an organization's responsibility to comply with l and state laws as it relates to privacy, security and confidentiality. Secure .gov websites use HTTPSA This License Agreement will not be governed by the United Nations Convention on Contracts for the International Sale of Goods, the application of which is expressly excluded. A Licensed User may not be an agent or consultant of a Licensee. All uses of these Third-Party Code Values may require a license from the copyright owner. We look forward to further dialogue . Except as provided for in Section II above, Licensee has no, and is not granted, any right, title, interest or other license in the Product. . The evaluator will assess the practice's progress towards recognition and provide immediate personalized feedback. New FAQs are posted on the 15 of every month(unless the 15 falls on a weekend). Any use of the Product to identify records or calculate HEDIS measure results, for example, requires a custom license and may necessitate certification pursuant to NCQAs Measure Certification Program. IX. NCQA Utilization Management Accreditation evaluates organizations performing full-scope utilization management services. These third party medical and billing codes are protected under federal copyright laws. We do not share your information with third parties. The headings contained in this License Agreement are for reference only and shall not affect the meaning or interpretation of this License Agreement. XII. 316 0 obj <>/Filter/FlateDecode/ID[]/Index[288 55]/Info 287 0 R/Length 126/Prev 726977/Root 289 0 R/Size 343/Type/XRef/W[1 3 1]>>stream RnI0O [.A <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> NCQA Corrections, Clarifications and Policy Changes to the 2021 HPA Standards and Guidelines July 26, 2021 Key = COCorrection, CLClarification, PCPolicy Change 4 PREVIOUSLY POSTED UPDATES Page Standard/Element Head/Subhead Update Type of Update IRT Release Date NCQA schedules the survey for submission 6 months following the last full We do not share your information with third parties. ModificationsThis License Agreement is the complete and exclusive statement of the agreement between Licensee and NCQA, and supersedes any proposal or prior agreement, oral or written, and any other communications between the parties relating to the subject matter of this License Agreement. For the best experience on our site, be sure to turn on Javascript in your browser. Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA.To verify compliance with this License Agreement, NCQA is granted the right, with prior notice and during normal business hours, to examine all relevant records of Licensee. A PDF reader is . XV. Licensee Representation and WarrantyLicensee represents and warrants to NCQA that this License Agreement shall be binding on Licensee, and, unless Licensee is an individual, Licensee represents and warrants that this License Agreement was executed by an authorized signatory of Licensee with the authority to enter into binding agreements on behalf of Licensee. x #-;g'bI&Z$@DD*.-;7Wu:orWm\|~uQmx! Limitation of LiabilityIN NO EVENT WILL NCQA BE LIABLE FOR ANY CONSEQUENTIAL, PUNITIVE, SPECIAL, INCIDENTAL, EXEMPLARY, INDIRECT OR OTHER SIMILAR DAMAGES, INCLUDING, WITHOUT LIMITATION, LOSS OR INACCURACY OF DATA, LOSS OF BUSINESS OR LOSS OF PROFITS ARISING OUT OF THE USE OR INABILITY TO USE THE PRODUCT, EVEN IF NCQA HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, AND IN NO EVENT SHALL NCQA BE RESPONSIBLE FOR ANY CLAIMS OF THIRD PARTIES. Copyright 2023 National Committee for Quality Assurance. endobj This later release date is because we are enhancing the survey tool (click here for additional information) for Health Plan Accreditation to help improve the customer experience. Except as provided for in Section II above, Licensee has no, and is not granted, any right, title, interest or other license in the Product. 0 Copyright 2023 National Committee for Quality Assurance. <> As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. Contact and NoticesShould Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. <>/Metadata 330 0 R/ViewerPreferences 331 0 R>> X. SeverabilityIf any portion of this License Agreement is determined by a court of competent jurisdiction or any appropriate legislature to be wholly or partially unenforceable, for any reason, such unenforceability shall not affect the balance hereof. 2020 Health Plan Survey Tool released (with standards included). THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EITHER EXPRESS OR IMPLIED, AS RELATED TO THE PRODUCT OR INFORMATION THEREIN, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Healthcare Effectiveness Data and Information Set (HEDIS), Chronic Condition Special Needs Plans (C-SNPs), Dual Eligible Special Needs Plans (D-SNPs), Institutional Special Needs Plans (I-SNPs), Use of Spirometry Testing in the Assessment and Diagnosis of COPD, Pharmacotherapy Management of COPD Exacerbation, Persistence of Beta-Blocker Treatment After a Heart Attack, Annual Monitoring for Patients on Persistent Medications, Potentially Harmful Drug-Disease Interactions in the Elderly, Use of High-Risk Medications in the Elderly, Osteoporosis Management in Women Who Had a Fracture, Follow-Up After Hospitalization for Mental Illness. stream The organization integrates the : following data for use in population management: . XVII. delivery, on behalf of the physician and patient community, we urge adoption of NCQA standards in this area. Licensed Users mean Licensees employees who may access and use the Product on behalf of the Licensee. The 2020 Health Plan Accreditation Standards and Guidelines were released on July 29, 2019. An organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. Licensee Representation and WarrantyLicensee represents and warrants to NCQA that this License Agreement shall be binding on Licensee, and, unless Licensee is an individual, Licensee represents and warrants that this License Agreement was executed by an authorized signatory of Licensee with the authority to enter into binding agreements on behalf of Licensee. VI. Any use of the Product to identify records or calculate HEDIS measure results, for example, requires a custom license and may necessitate certification pursuant to NCQAs Measure Certification Program. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. View Table of Contents for this Publication. NCQA sets standards for interpreting NCQA Accreditation standards and HEDIS measures. The individual accepting this License Agreement on behalf of Licensee represents that by electronically signing this License Agreement, the individual hereby binds the Licensee to the terms of this License Agreement, and that such individual is an employee of Licensee and duly authorized to enter into and bind Licensee to the terms of this License Agreement. Licensee acknowledges and agrees that it is responsible for obtaining a license directly from the copyright owner of each of the Third-Party Code Values, if required. Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. 3.0 : May 2019 An explanation of the 8 and 30 file sampling procedure used by NCQA during accreditation survey visits. VII. tG+~zM~8j 0 ( Upon termination of this License Agreement, all rights under this License Agreement, including the license granted to Licensee, will cease. SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF IMPLIED WARRANTIES OR LIMITATIONS ON HOW LONG IMPLIED WARRANTIES MAY LAST, SO THE ABOVE LIMITATIONS AND EXCLUSIONS MAY NOT APPLY TO YOU. NCQAs failure to exercise or enforce any right or power under this License Agreement shall not constitute a waiver of such right or power. XVII. To ACCEPT this License Agreement, click the accompanying checkbox/button to accept the terms of this product, which will create a legal contract that will bind Licensee and NCQA. 2020 Core Set of Behavioral Health Measures for Medicaid and CHIP (Behavioral Health Core Set) To support CMS's efforts to improve behavioral health in Medicaid and CHIP, CMS identified a core set of 18 behavioral health measures for voluntary reporting by state Medicaid and CHIP agencies. %BX{^4.bygeB;GO NOTE: This License Agreement is null and void as related to the following NCQA Products (as such term is defined in Section I below): Risk Adjustment Tables, HEDIS Medication List Directory and CA DHCS QIP (any) Edition of HEDIS Digital Measures Bundle For ECDS Reporting. Read this License Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. All other uses, including a commercial use (including but not limited to vendors or consultants using or embedding the measures and specifications and/or Value Set Directory 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. Member confidentiality. EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2020 ONWARD. Requirements cover these key areas: To see all program requirements, get the Standards and Guidelines document. All notices to be given under this License Agreement to Licensee shall be submitted by NCQA via e-mail at the account Licensee provided to NCQA. XI. Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status. <> Specifications for the Medicare Health Outcomes Survey, Case Management (CM) and Long-Term Services and Supports (LTSS), Managed Behavioral Healthcare Organizations (MBHO), Utilization Management/Credentialing/Provider Network (UM/CR/PN), Credentials Verification Organizations (CVO), Patient-Centered Specialty Practice (PCSP), California Align Measure Perform (AMP) & Value Based Pay for Performance (VBP4P), Skip to the beginning of the images gallery. 2017 NCQA further advanced its PCMH program through Recognition Redesign. %PDF-1.7 TerminationNCQA may terminate this License Agreement at any time and without notice if Licensee violates any of the terms and conditions hereof. endobj 2019 Clinical Quality Measure Flow Narrative for Quality ID #236 NQF #0018: Controlling High Blood Pressure endstream endobj 1817 0 obj <>stream endstream endobj startxref "Y`>X ?H D $WZ vd7k +LF8#Dte`bd`\8^ XII. 1. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. XVII. Requirements cover these key areas: Applying an internal QI process. Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status, New Requirements and Consumer Protections, Health Plan Accreditation 2020: Standards and Survey Tool Release Dates. 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 THE PRODUCT OR ANY PART THEREOF, OR THIS LICENSE AGREEMENT, EXCEED THE PRICE PAID FOR THE PRODUCT, WHETHER SUCH LIABILITY ARISES FROM ANY CLAIM BASED ON CONTRACT, WARRANTY, TORT OR OTHERWISE. G'a8 z ,hI:0` Mdm9V@ (wXb&WjuYQJEQ5eadzT jh-&I8$8r1'5~67Ub3l8yG-!pv+zO'D-Zw_5#%Rx:D9G`/nRR>@|9t,"aRZU6 SBi8"?^B9H6-JX/lODx{&A:Gu{&mX|=Iq 3""}%m/2\u9t.qo*OeY},cRU\XJtNI\@2i: 2dcxhJ3sa64 ) Governing Law and General ProvisionsThis License Agreement shall be governed and construed in accordance with the laws of the District of Columbia without regard to its choice of laws. Anyone contemplating a use beyond a personal, non-commercial use, including but not limited to a commercial use, internal or external reproduction, distribution or publication of any part of a Product or use of a Product to identify records or calculate HEDIS measure results, must contact the NCQA licensing team by submitting a request through https://my.ncqa.org to discuss the need for a license.Licensee agrees and understands that any score or numeric result calculated from access and use of the Product does not constitute a preliminary or final score and does not predict achievement of accreditation, certification or recognition, as applicable. Copyright 2023 National Committee for Quality Assurance. 2019 Clinical Quality Measure Flow Narrative for Quality ID #50: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older Please refer to the specific section of the specification to identify the denominator and numerator information for use in submitting this Individual Specification. % All uses of these Third-Party Code Values may require a license from the copyright owner. 2'sYP'IeIFH5-st#,Z5v&*}"xC0!"#:#}?rjJS',#l2u)h3p+a:fRlA8E@9~fBa"=KQY(?\mq1)gg$\y#cvnG54h0'[#0YNdR8}2e. NCQA Element . Upon termination of this License Agreement, all rights under this License Agreement, including the license granted to Licensee, will cease. TerminationNCQA may terminate this License Agreement at any time and without notice if Licensee violates any of the terms and conditions hereof. The License is not transferable from Licensee to any other person, entity, organization or association. NCQA Utilization Management Accreditation is designed to ensure that organizations can consistently make appropriate and timely decisions. PCMH Incentive: Primary care practices are offered a per- member per-month incentive to become recognized by NCQA as a PCMH, which necessitates quality improvement projects. BECAUSE SOME STATES OR JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES (SUCH AS CONSEQUENTIAL OR INCIDENTAL DAMAGES), OR THE EXCLUSION OF IMPLIED WARRANTIES AND LIMITATIONS ON HOW LONG AN IMPLIED WARRANTY MAY LAST, THE ABOVE LIMITATIONS MAY NOT APPLY TO LICENSEE, TO THE EXTENT THAT LIABILITY IS, BY LAW, INCAPABLE OF EXCLUSION OR RESTRICTION. tc;m1aIb 2F%At/|b^-x({N&R26y H4>1=.~MClx-ikqGbg Contact and Notices. Licensee agrees to indemnify and hold NCQA harmless from any claims and expenses arising out of Licensees use and display of Third-Party Code Values included in the HEDIS VSDs, or any portion thereof. For Value Set Directory (VSD) Downloads. We do not share your information with third parties. Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. SurvivalThe provisions of Sections V, VII and VIII of this License Agreement shall survive the termination of this License Agreement. The headings contained in this License Agreement are for reference only and shall not affect the meaning or interpretation of this License Agreement. Copyright Notice RequiredThe Product contains proprietary and copyrighted information and notice to that effect must appear on all authorized copies of the Product made by Licensee under this License Agreement. HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance. You will be prompted to log in to your NCQA account. The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. NCQA holds a copyright in the measures and specifications and may rescind or alter these measures and specifications at any time. 11/25/2019 3:59:12 PM . NCQA Accreditation: MCOs are required to be accredited, which necessitates continuous analysis of opportunities to improve coordination of care. IV. To DECLINE this License Agreement, do not proceed and contact My NCQA with any questions or concerns or request for a custom license agreement to meet your needs. &eNA!$}(5I6KA"+D}Qt\V+Zs1eM6fz:srrhdkqJ)> *>ogVwIHL)xL\0BZb)Ct>#5L9VQSUHU?8.ttE3zVu8bq-&. 9.v h)f -2OJ v)TXS=p 8U&s$\m Following DATA for use in population Management: for which a Licensee terms conditions. Ncqa sets standards for interpreting NCQA Accreditation standards and HEDIS measures be accredited, which necessitates continuous of... 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