The Product is being licensed (not sold) to you, the Licensee (the License). (PDF). Copyright 2023 National Committee for Quality Assurance. endstream endobj startxref Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. New FAQs are posted on the 15 of every month(unless the 15 falls on a weekend). THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PRODUCT IS WITH THE LICENSEE. <> % Share this page with a friend or colleague by Email. Requirements cover these key areas: Applying an internal QI process. RnI0O [.A XVII. 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. An explanation of the 8 and 30 file sampling procedure used by NCQA during accreditation survey visits. Using appropriate professionals. Share this page with a friend or colleague by Email. h\AN@E27dRTQbQB*=vX{r$e K8Z+*;e_?St*[|e[o-;/6MpnC\Hdy rL|LIr2e_D,F1+^1W+s N$oK)R493{py #xtV>zxk13No9:C_ eH__C/WpGOav4 Eligible organizations: Note: Members refers to membership of clients and organizations. In the event NCQA receives notification within the warranty period of any defects in the media, NCQA will, at its option, either replace such defective media or return to Licensee the price paid for the Product. Data allow identification of performance gaps and establishment of realistic targets for improvement. \bMQ!HQd2`/_$EFcGI'.mG_|qxcB3XLf. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. Share sensitive information only on official, secure websites. 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). Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. 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. XIV. Contact and NoticesShould Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. HEDIS Measures relate to many significant . Contact and NoticesShould Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. SNPs reported the following measures in HEDIS 2016: Please see the links below for the most recent SNP HEDIS Reports released by NCQA. N Requirements cover these key areas: To see all program requirements, get the Standards and Guidelines document. 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. For the best experience on our site, be sure to turn on Javascript in your browser. 0 NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. SNPs can use HEDIS performance data to identify opportunities for improvement, monitor the success of quality improvement initiatives, track improvement, and provide a set of measurement standards that allow comparison with other plans. THE LIMITATIONS OF DAMAGES AND LIABILITIES SET FORTH IN THIS LICENSE AGREEMENT ARE FUNDAMENTAL ELEMENTS OF THE BASIS OF THE BARGAIN BETWEEN NCQA AND LICENSEE, AND THE PRICING FOR THE LICENSE REFLECTS SUCH LIMITATIONS. 0 Anyone desiring broader internal distribution of the Product must purchase additional Licensed User permissions via the NCQA Store. I. ProductThis version and any updates to this version provided by NCQA, whether in hard copy or electronic publication, and any related documentation, including, but not limited to, the user's manual, unless provided under the terms of a separate license agreement (collectively, the "Product"). The organization integrates the : following data for use in population management: . HEDIS VSDs contain code values owned by third parties (the Third Party Code Values), including CPT owned by American Medical Association, LOINC owned by Regenstrief Institute, Inc., SNOMED CT owned by the International Health Terminology Standards Development Organisation, and Uniform Billing Codes owned by the American Hospital Association. Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. Start with . 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. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. All notices to be given under this License Agreement to NCQA shall be submitted to NCQA at 1100 13th Street NW, Washington, D.C. 20005, Attention: Licensee Support. 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. NCQA Utilization Management Accreditation is for organizations that provide full-scope utilization management services. 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. More than 12,000 practices (with more than 60,000 clinicians) are recognized by NCQA. The 2020 HP Survey Tool was released on March 30, 2020. NCQA PCMH 2017 Standards Intro 3/29/18 4 A check-in will be conducted virtually online with an NCQA evaluator. Contact and Notices. XII. . Users of the measures and specifications shall not have the right to alter, enhance or . Remedies and AuditAny breach of this License Agreement of any terms herein by Licensee may cause irreparable harm to NCQA for which no adequate remedy at law exists and may subject Licensee to injunctive relief and all legal and equitable remedies available to NCQA, including, but not limited to, recovery of all costs and expenses, including reasonable attorney's fees incurred because of any such legal action. HEDIS VSDs are made separately available, at no cost, in electronic format. and Scoring NCQA Requirements Additional NCQA Guidance ; PHM 2 Element A; To fully meet the criteria the organization must meet 3-7 factors. ) At this time, you can order: Save your favorite pages and receive notifications whenever theyre updated. 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. % The National Committee for Quality Assurance Patient-Centred Medical Home (NCQA-PCMH) is officially recognised as a quantitative assessment tool of institutional evaluation (supply-side) [ 9 ], and the PCAT is widely used as a quantitative assessment tool for patient evaluation (demand-side) [ 10 ]. Users must still click the I AGREE checkbox at the end of this License Agreement to access those Products, but the terms of this License Agreement will have no legal effect. 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. HEDIS VSDs contain code values owned by third parties (the Third Party Code Values), including CPT owned by American Medical Association, LOINC owned by Regenstrief Institute, Inc., SNOMED CT owned by the International Health Terminology Standards Development Organisation, and Uniform Billing Codes owned by the American Hospital Association. 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. Focus areas to ensure high quality. 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. hbbd```b``~"R @Xn^xJps A Licensed User must be using the Product under the License and solely on behalf of the Licensee. Licensee acknowledges that the Product remains the full and exclusive property of NCQA. or In the event NCQA receives notification within the warranty period of any defects in the media, NCQA will, at its option, either replace such defective media or return to Licensee the price paid for the Product. -LTSS Accreditation policies and procedures under 5: Additional Information.) As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. ( 3 0 obj ht[$'DK $}fpf . National Committee for Quality Assurance (NCQA)* Medicaid Healthcare Maintenance Organization Accreditation** Version Date: July 1, 2019 Accreditation Level Description of Accreditation Level Denied NCQA awards a status of Denied Accreditation to organizations whose programs for service and clinical quality do not meet NCQA requirements. IF APPLICABLE, LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF THE PRODUCT. The 2020 Health Plan Accreditation Standards and Guidelines were released on July 29, 2019. y(ALshU~ NmuE)T"Z5]qhhiP3f[T+zSE'1I-Zg}T8kcm0GKS-vcEZ)/^d_S!CQK|]Q8mAaZ3x0Q*8I!9fXf=?OL8S-}ZTf2){C[${" ]n uA^3)_=Ygu/!~O{>w;^ w5q Y+ e=`^Y%GeUPFP K~#s May 2019 : Updated examples of logic as needed to reflect most recent use . ePub: A downloadable PDF version of the standards, Web-based: A license to access a web-based version of the standards through IRT. 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 EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2020 ONWARD. You will be prompted to log in to your NCQA account. stream NCQA Credentialing Standards Overviewand 2022 Updates part of the AMA Credentialing Insights Webinar Series 6/23/2022 2022 AmericanMedica l Association. 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. If the military hospital or clinic can't get you an appointment with your primary care manager within the access standards (within 24 hours - 1 day), they will get you an appointment with another provider. Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. NCQA will release the 2021 Health Plan Ratings (HPR) for all product lines in September 2021. 133 0 obj <>stream For Value Set Directory (VSD) Downloads. 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. <> Hard copies of 2020 Health Plan Accreditation Standards and Guidelines available for purchase. If any part of this License Agreement is found void and unenforceable, it will not affect the validity of the remainder of the License Agreement, which shall remain valid and enforceable according to its terms. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> IX. 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. O0 ooaM[T5io'B\SR3"p8`,RD3h0I2Zz|ks/MpT,fN2ft~Rye.CqAIbx4A)UKyir{c8EC%?`U-`pBRN?fiG&pF9."hA*=WMBpbp-}a]e594v #03Tqi1(zk[ q4LD THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PRODUCT IS WITH THE LICENSEE. Users must still click the I AGREE checkbox at the end of this License Agreement to access those Products, but the terms of this License Agreement will have no legal effect. Should Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. CMS contracted with NCQA to develop a strategy to evaluate the quality of care provided by SNPs. 3.0 : May 2019 . [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 { All notices to be given under this License Agreement to NCQA shall be submitted to NCQA at 1100 13th Street NW, Washington, D.C. 20005, Attention: Licensee Support. %PDF-1.6 % 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. h[k1B{%~3:sF4&%=! 19\-% wq43-TY^yTk$8JkMVj$MX:v2Zz;I;Y; License GrantNCQA hereby grants Licensee a personal, non-exclusive, non-transferable license to use the Product in accordance with the terms of this License Agreement. https:// III. JavaScript seems to be disabled in your browser. 3.0 : May 2019 . 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