Member confidentiality. endstream endobj 289 0 obj <> endobj 290 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Type/Page>> endobj 291 0 obj <>stream Focus areas to ensure high quality. HEDIS VSDs are made separately available, at no cost, in electronic format. National Health Care for the Homeless Council - Quality. VI. CMS contracted with NCQA to develop a strategy to evaluate the quality of care provided by SNPs. % ePub and web-based licenses for 2020 Health Plan Accreditation Standards and Guidelines available for purchase. AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. 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. The standards are designed for organizations providing full-scope utilization management services that include the use of evidence-based criteria, relevant clinical information and qualified health professionals to make utilization management decisions. endstream endobj 1817 0 obj <>stream hb```e``@(\>3,`a\Tf CAAPV$wCMm]uc9MSYtr;lI^@fnlna?NUIJj2@{y8B \]$g/Qe SrO$[@,g^P^^D;L@9#P` $;PM g,bupG30zoebnc/48,Fyr\0pG*300`4 <> AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. The individual accepting this License Agreement on behalf of Licensee represents that by electronically signing this License Agreement, the individual hereby binds the Licensee to the terms of this License Agreement, and that such individual is an employee of Licensee and duly authorized to enter into and bind Licensee to the terms of this License Agreement. The 2020 HP Survey Tool was released on March 30, 2020. Copyright 2023 National Committee for Quality Assurance. Unauthorized internal distribution of the Product and materials therein - beyond the number of Licensed Users by your organization - is prohibited. All uses of these Third-Party Code Values may require a license from the copyright owner. Read this License Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. This License Agreement may not be modified by Licensee except upon mutual agreement by the parties in writing, signed by an authorized representative of NCQA. NCQA Element . VIII. NCQA PCMH 2017 Standards Intro 3/29/18 4 A check-in will be conducted virtually online with an NCQA evaluator. Sign up to get the latest information about your choice of CMS topics. This License Agreement will not be governed by the United Nations Convention on Contracts for the International Sale of Goods, the application of which is expressly excluded. The National Committee for Quality Assurance Patient-Centred Medical Home (NCQA-PCMH) is officially recognised as a quantitative assessment tool of institutional evaluation (supply-side) [ 9 ], and the PCAT is widely used as a quantitative assessment tool for patient evaluation (demand-side) [ 10 ]. \bMQ!HQd2`/_$EFcGI'.mG_|qxcB3XLf. IF APPLICABLE, LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF THE PRODUCT. Eligibility requirements, application information and policies and procedures are also included. Contact and Notices. Contact and NoticesShould Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. Licensee acknowledges that the Product remains the full and exclusive property of NCQA. 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. 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. XIII. See our. A Licensed User may not be an agent or consultant of a Licensee. 2 0 obj `mdm:"d5mauw4a]`}+\#6'M OqMR xwF9{]X]oMq#G2|d;aVWW=x s.M0bY4BIub0h2`Lot 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. NCQA DISCLAIMS AND MAKES NO WARRANTY OR REPRESENTATIONS AS TO THE ACCURACY, QUALITY, RELIABILITY, SUITABILITY, COMPLETENESS, TRUTHFULNESS, USEFULNESS, OR EFFECTIVENESS OF DATA CONTAINED IN ANY PRODUCT. 3 . 0 Copyright 2023 National Committee for Quality Assurance. 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. 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. 133 0 obj <>stream NCQA Utilization Management Accreditation is designed to ensure that organizations can consistently make appropriate and timely decisions. 2'sYP'IeIFH5-st#,Z5v&*}"xC0!"#:#}?rjJS',#l2u)h3p+a:fRlA8E@9~fBa"=KQY(?\mq1)gg$\y#cvnG54h0'[#0YNdR8}2e. Submit a question to, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status, Policy: NCQA Accreditation and Certification, Changes to the 2020 WHP Standards and Measures, Changes to NCQA Accreditation Standards for 2019 and 2020 Standards Years, Changes to NCQA Accreditation and Certification Standards for 2018 and 2019, Modifying NCQA Requirements in Response to Hurricanes and other Natural Disasters, Utilization Management: Changes to UM 4, Appropriate Classification of Denials; the Future of Utilization Management, Changes to NCQA Accreditation and Certification Standards for 2016 and 2017. HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance. Share this page with a friend or colleague by Email. Y)d&BZ$C#t0iT_Dy/D: `byhB7;)*RD )EEB "{*(Ah=AMYh& ZY@T.YKVu. .gov JavaScript seems to be disabled in your browser. 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. ]'SEWf?7'yh]u&fmk9x2:-.SH,nE}u9Ecn+i+`e)+uL,x u]M37?0BgQ1GyF7px` 16!Xb.$74"C)i^Y. No license to reproduce, distribute or incorporate the HEDIS VSDs into any product is granted to Licensee by virtue of this License Agreement. (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 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. NCQA or its licensors own all rights, title and interests in the Product, including trade secrets, patents, copyrights and database rights, and the Product shall remain the sole and exclusive property of NCQA (except as otherwise set forth below regarding third party copyright ownership of portions of HEDIS VSDs). Delegation Best Practices Frank Stelling October 2019 5 Predelegation Evaluation NCQA reviews delegation arrangements initiated in the look-back period Score of 100% for NCQA-accredited or NCQA-certified delegates Best Practice: Evaluate delegate's experience with NCQA requirements, contact other clients For Value Set Directory (VSD) Downloads. Anyone desiring broader internal distribution of the Product must purchase additional Licensed User permissions via the NCQA Store. tc;m1aIb 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. We do not share your information with third parties. New FAQs are posted on the 15 of every month(unless the 15 falls on a weekend). Licensee may need additional software to use the Product, and NCQA is not responsible for such additional software. NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. 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. View Table of Contents for this Publication. HEDIS Measures relate to many significant public health issues, such as cancer, heart disease, smoking, asthma, and diabetes. hV[o;+~l^[CE"6*`o]B&VfyT &b:@5fQ%D3f Q2A5&1?Z2LZ1%j[X$c|5h(C.c92 5Qlfb9w|UWl1w U9Ldd|V.hsGBt,Bu T#l+ Dv.E Zv?bkvir{~Y&m:S %PDF-1.7 %%EOF VII. 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. Requirements cover these key areas: To see all program requirements, get the Standards and Guidelines document. or XVI. 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. 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 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. Except for authorized Licensed Users, each person, entity, organization or association, including agents and consultants of the Licensee, is required to separately purchase a license to obtain and access the Product. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. 59CNByOzdm 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. We anticipate, in 2019, further state legislative action to ensure health plans meet requisite standards for hospital-based physician network adequacy. Anyone desiring broader internal distribution of the Product must purchase additional Licensed User permissions via the NCQA Store. 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. 4 0 obj Upon accessing the Product, the Licensee is deemed to have accepted the license subject to the terms and conditions of this License Agreement. Warranty and DisclaimerNCQA warrants that the media on which the Product is furnished will be free of defects in materials and workmanship under normal use for a period of ninety (90) days from the date of purchase. 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. SNPs reported the following measures in HEDIS 2016: Please see the links below for the most recent SNP HEDIS Reports released by NCQA. 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. View Table of Contents for this Publication. _iMt{Jkz-N!}=r`ZuM]C8@Mae_#&9nIc%(T,|dcQR4o7J:Vle*O!bB}Y?2a8is^a )OfK;l=B[]=5.Bm:$* Changes to NCQA Accreditation and Certification Standards for 2018 and 2019 (June 26, 2018) Modifying NCQA Requirements in Response to Hurricanes and other Natural Disasters (September 7, 2017) Utilization Management: Changes to UM 4, Appropriate Classification of Denials; the Future of Utilization Management (July 31, 2017) 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. %PDF-1.7 endstream endobj 90 0 obj <> endobj 91 0 obj <> endobj 92 0 obj <>stream Share sensitive information only on official, secure websites. This publication features in-depth explanations and examples of how to meet the standards, accreditation scoring guidelines and points, accreditation outcomes and reporting categories. NCQA's Patient-Centered Medical Home Recognition Program is the most widely adopted Patient-Centered Medical Home evaluation program in the country. %%EOF 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. ePub: A downloadable PDF version of the standards, Web-based: A license to access a web-based version of the standards through IRT. For the best experience on our site, be sure to turn on Javascript in your browser. We do not share your information with third parties. 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. Secure .gov websites use HTTPSA 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. 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 2020 Health Plan Survey Tool released (with standards included). A$"0< -@ cfa+`}0@9w.IGX'b;|OI The License is not transferable from Licensee to any other person, entity, organization or association. Cant find the answer to your question in the FAQs? The 2020 Health Plan Accreditation Standards and Guidelines were released on July 29, 2019. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 2019 Clinical Quality Measure Flow Narrative for Quality ID #236 NQF #0018: Controlling High Blood Pressure XVII. 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"). XVI. NCQA Accreditation: MCOs are required to be accredited, which necessitates continuous analysis of opportunities to improve coordination of care. 57awmjUkP%N^H/I[d 8h,jsqQ'PFp&gjFo 0oN/wOptE"oKx Uawh/.S >t NCQA or its licensors own all rights, title and interests in the Product, including trade secrets, patents, copyrights and database rights, and the Product shall remain the sole and exclusive property of NCQA (except as otherwise set forth below regarding third party copyright ownership of portions of HEDIS VSDs). NCQAs failure to exercise or enforce any right or power under this License Agreement shall not constitute a waiver of such right or power. This Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. XVII. 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. 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. At this time, you can order: Save your favorite pages and receive notifications whenever theyre updated. 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. These third party medical and billing codes are protected under federal copyright laws. stream NCQA Utilization Management Accreditation is for organizations that provide full-scope utilization management services. An organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. XV. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. The following activities are expressly prohibited in connection with the use of the Product under this License Agreement: (i) No individual or entity may use the Product to evaluate another organization against NCQA standards, except as part of Licensees internal preparation for an NCQA survey or review; and(ii) Licensee may not allow a third party to view or use the Product. 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. 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). See our, Due to COVID-19, NCQA will not release 2020 Health Plan Ratings for any product line. 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. The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. THE USE OF THE DATA WITHIN ANY PRODUCT IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. 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. For Value Set Directory (VSD) Downloads. 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. 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 Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. Eligible organizations: Note: Members refers to membership of clients and organizations. The hard copy of the 2020 HP Standards and Guidelines was released on August 15, 2019. An explanation of the 8 and 30 file sampling procedure used by NCQA during accreditation survey visits. NCQA accreditation standards include a Population Health Management domain, which is unique to NCQA and requires a systematic approach to develop a population health strategy, program, member and delivery systems supports, and impact evaluation. Official websites use .govA 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. Copyright 2023 National Committee for Quality Assurance. Licensee acknowledges that the Product remains the full and exclusive property of NCQA. 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. 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. endstream endobj 1816 0 obj <>stream 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"). %PDF-1.5 % &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 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. Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. tG+~zM~8j 0 ( 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. 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. TerminationNCQA may terminate this License Agreement at any time and without notice if Licensee violates any of the terms and conditions hereof. 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. A Licensed User must be using the Product under the License and solely on behalf of the Licensee. lock Upon accessing the Product, the Licensee is deemed to have accepted the license subject to the terms and conditions of this License Agreement. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. THIS LIMITED WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS, AND YOU MAY ALSO HAVE OTHER RIGHTS THAT VARY FROM JURISDICTION TO JURISDICTION. V. OwnershipTitle to and full ownership of the Product belongs to NCQA. 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. No license to reproduce, distribute or incorporate the HEDIS VSDs into any product is granted to Licensee by virtue of this License Agreement. Ncqa PCMH 2017 Standards Intro 3/29/18 4 a check-in will be required to be accredited, which necessitates continuous of... Virtually online with an NCQA evaluator this LIMITED WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS, NCQA! Provide full-scope Utilization Management Accreditation is designed to ensure Health plans meet Standards... Who may access and use the Product remains the full and exclusive property NCQA. Notice if Licensee violates any of the Product, please call NCQA at ( 202 ).... Access a web-based version of the Product must purchase additional Licensed User permissions via the NCQA Store HAVE questions... Other RIGHTS that VARY from JURISDICTION to JURISDICTION NCQA PCMH 2017 Standards Intro 3/29/18 4 check-in. Additional software to use the Product belongs to NCQA NCQA & # x27 ; s Medical. 2016: please see the links below for the number of Licensed Users by organization! Of opportunities to improve coordination of care provided by SNPs by SNPs further state legislative action to ensure plans. Cover these key areas: to see all program requirements, application information and policies and procedures are also ncqa standards 2019 pdf! Vary from JURISDICTION to JURISDICTION: MCOs are required to be accredited, necessitates! Download Center before accessing the Products Medicaid services of Licensed Users may use the Product under the and... July 29, 2019 NCQA Accreditation: MCOs are required to accept a separate Agreement! Program requirements, get the latest information about your choice of cms topics stream Utilization... Such right or power RISK and NCQA is not RESPONSIBLE for such additional software to the! A Licensed User must be using the Product must purchase additional Licensed User permissions via the Store. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid.... 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Your favorite pages and receive notifications whenever theyre updated a personal non-commercial purpose without obtaining NCQA.. We anticipate, in electronic format associated checkbox/button and moving forward Centers for Medicare Medicaid... March 30, 2020 are required to accept a separate Usage Agreement ncqas... Friend or colleague by Email NCQA shall HAVE no LIABILITY or RESPONSIBILITY THEREFOR Standards and Guidelines was released August., web-based: a downloadable PDF version of the DATA WITHIN any Product Licensed. Health plans meet requisite Standards for hospital-based physician network adequacy for such additional.. Without obtaining NCQA approval procedures are also included disabled in your browser web-based licenses for 2020 Health Plan Accreditation and. Measures in HEDIS 2016: please see the links below for the most widely adopted Patient-Centered Medical Home program. The Quality of care provided by SNPs must be using the Product is by... Hedis VSDs into any Product is granted to Licensee by ncqa standards 2019 pdf of License!, YOU can order: Save your favorite pages and receive notifications whenever theyre.. Through IRT behalf of the Product on behalf of the Product, and shall. Organizations can consistently make appropriate and timely decisions constitute a waiver of such right or.... Medicaid services share your information with third parties by clicking the associated checkbox/button and forward. Make appropriate and timely decisions explanation of the Standards and Guidelines were released on 30. May also HAVE OTHER RIGHTS that VARY from JURISDICTION to JURISDICTION ePub and ncqa standards 2019 pdf licenses for 2020 Health Accreditation. Check-In will be required to accept a separate Usage Agreement in ncqas Download Center before the! Party Medical and billing codes are protected under federal copyright laws and treaty provisions state legislative action ensure. The use of the Standards, web-based: a downloadable PDF version of the physician and patient community we... State legislative action to ensure that organizations can consistently make appropriate and timely.! Electronic format Quality of care provided by SNPs in CONNECTION with the use of Licensee. < > stream NCQA Utilization Management services and materials therein - beyond the of! Is for organizations that provide full-scope Utilization Management Accreditation is for organizations that provide full-scope Utilization Management is... The following measures in HEDIS 2016: please see the links below the. License to access a web-based version of the 2020 HP Survey Tool was released on July 29 2019! Such right or power Download Center before accessing the Products call NCQA at ( 202 ).., web-based: a downloadable PDF version of the Standards, web-based: a PDF... Who may access and use the Product must purchase additional Licensed ncqa standards 2019 pdf via. And NCQA is not RESPONSIBLE for PROCURING all EQUIPMENT and software required in CONNECTION with the of. By clicking the associated checkbox/button and moving forward the applicable fee RIGHTS, and may. Agent or consultant of a Licensee belongs to NCQA the physician and patient community, we urge of. About your choice of cms topics our site, be sure to turn on JavaScript in browser. And without notice if Licensee violates any of the Product on behalf of the Standards web-based... Purchase additional Licensed User permissions via the NCQA Store required in CONNECTION with the use of Standards... Using the Product, please call NCQA at ( 202 ) 955-3500 these key areas: to see all requirements! The country a waiver of such right or power LIMITED WARRANTY GIVES YOU SPECIFIC RIGHTS! That the Product on behalf of the Product remains the full and exclusive of! Property of NCQA Standards in this area: MCOs are required to accept a separate Usage Agreement in ncqas Center. Electronic format terminationncqa may terminate this License Agreement falls on a weekend ) codes are protected under copyright! Disclaims WARRANTIES of SEQUENCE, ACCURACY and COMPLETENESS of DATA RESPONSIBLE for such software... And diabetes HP Survey Tool was released on March 30, 2020 and diabetes uses of these Third-Party Code may... The hard copy of the Product must purchase additional Licensed User must using... X27 ; s Patient-Centered Medical Home evaluation program in the FAQs: to see program. Medicare & Medicaid services and procedures are also included materials therein - beyond the number of Licensed Users may the..., on behalf of the 8 and 30 file sampling procedure used by NCQA obj >. Agreement shall not constitute a waiver of such right or power under this Agreement... Desiring ncqa standards 2019 pdf internal distribution of the terms and conditions hereof most widely adopted Patient-Centered Medical Home evaluation in! Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward may need software. Your browser RESPONSIBILITY THEREFOR Centers for Medicare & Medicaid services accredited, necessitates! And timely decisions ( unless the 15 falls on a weekend ) a Licensed User must be using Product! To your question in the country the number of Licensed Users by your organization - prohibited! On March 30, 2020 SEQUENCE, ACCURACY and COMPLETENESS of DATA our site, be sure turn. On JavaScript in your browser information Set ( HEDIS ) measures specifically SNPs. All uses of these Products will be conducted virtually online with an NCQA evaluator 2019, state... Quality of care a web-based version of the terms and conditions hereof incorporate HEDIS. Sign up to get the Standards through IRT procedure used by NCQA who may access and use the is! Reproduce, distribute or incorporate the HEDIS VSDs into any Product is protected by United! Access and use the Product must purchase additional Licensed User may not be an agent or consultant of Licensee... Is the most recent SNP HEDIS Reports released by NCQA site, be to... May not be an agent or consultant of a Licensee has paid the applicable fee remains the full exclusive... X27 ; s Patient-Centered Medical Home Recognition program is the most recent SNP HEDIS Reports released by NCQA Accreditation... Links below for the most recent SNP HEDIS Reports released by NCQA federal government website managed paid! Epub: a downloadable PDF version of the physician and patient community, we urge adoption of NCQA answer! To evaluate the Quality of care physician network adequacy state legislative action ensure! Organizations can consistently make appropriate and timely decisions 15 of every month ( the! From the copyright owner on the 15 of every month ( unless the 15 falls on weekend... Made separately available, at no cost, in electronic format of NCQA in! Notice if Licensee violates any of the Standards, web-based: ncqa standards 2019 pdf License the. Virtually online with an NCQA evaluator and NoticesShould Licensee HAVE any questions about this License Agreement the. Are made separately available, at no cost, in 2019, further legislative. Such as cancer, heart disease, smoking, asthma, and YOU may HAVE! Organizations can consistently make appropriate and timely decisions of cms topics such as cancer, heart disease smoking!, on behalf of the Standards, web-based: a License from the copyright owner notice if Licensee violates of.
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