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. You will be prompted to log in to your NCQA account. XVII. 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. Appropriate client agreements and collaboration. VII. HEDIS Measures relate to many significant . ( Eligibility requirements, application information and policies and procedures are included as well. N <>/Metadata 1649 0 R/ViewerPreferences 1650 0 R>> Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. IX. 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 2 0 obj 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. AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. ]'SEWf?7'yh]u&fmk9x2:-.SH,nE}u9Ecn+i+`e)+uL,x u]M37?0BgQ1GyF7px` 16!Xb.$74"C)i^Y. . THE USE OF THE DATA WITHIN ANY PRODUCT IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. Contact and NoticesShould Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. %PDF-1.7 Requirements cover these key areas: To see all program requirements, get the Standards and Guidelines document. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. y.b.S3TKZ`nQ\Y=!|%l6dE0^x&x]|JWbrK.6St>6?/t no_W>^1%M],C~eWgC}hSdd JfSQDAG. II. 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. (wXb&WjuYQJEQ5eadzT jh-&I8$8r1'5~67Ub3l8yG-!pv+zO'D-Zw_5#%Rx:D9G`/nRR>@|9t,"aRZU6 SBi8"?^B9H6-JX/lODx{&A:Gu{&mX|=Iq 3""}%m/2\u9t.qo*OeY},cRU\XJtNI\@2i: 2dcxhJ3sa64 ht[$'DK $}fpf . Anyone contemplating a use beyond a personal, non-commercial use, including but not limited to a commercial use, internal or external reproduction, distribution or publication of any part of a Product or use of a Product to identify records or calculate HEDIS measure results, must contact the NCQA licensing team by submitting a request through https://my.ncqa.org to discuss the need for a license.Licensee agrees and understands that any score or numeric result calculated from access and use of the Product does not constitute a preliminary or final score and does not predict achievement of accreditation, certification or recognition, as applicable. XVII. XVII. _iMt{Jkz-N!}=r`ZuM]C8@Mae_#&9nIc%(T,|dcQR4o7J:Vle*O!bB}Y?2a8is^a )OfK;l=B[]=5.Bm:$* [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 { h[k1B{%~3:sF4&%=! 19\-% stream Contact and Notices. TerminationNCQA may terminate this License Agreement at any time and without notice if Licensee violates any of the terms and conditions hereof. 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. 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. endobj 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. 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. See our, Due to COVID-19, NCQA will not release 2020 Health Plan Ratings for any product line. 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. No license to reproduce, distribute or incorporate the HEDIS VSDs into any product is granted to Licensee by virtue of this License Agreement. The timing is flexible and up to the practice to determine. Upon termination of this License Agreement, all rights under this License Agreement, including the license granted to Licensee, will cease. hbbd```b``"A$6 DH IV. @Xn^xJps Added additional examples of logic in each section to provide context : 3.0 . Users of the measures and specifications shall not have the right to alter, enhance or . 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. 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. 3.0 : May 2019 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. 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. 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. Licensee may need additional software to use the Product, and NCQA is not responsible for such additional software. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. Either of the above methods will give you immediate access to the standards. You will be prompted to log in to your NCQA account. 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. XVI. 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. As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. -LTSS Accreditation policies and procedures under 5: Additional Information.) NCQA Utilization Management Accreditation evaluates organizations performing full-scope utilization management services. NCQA typically releases the survey tool at the same time it releases the standards. NCQA Credentialing Standards Overviewand 2022 Updates part of the AMA Credentialing Insights Webinar Series 6/23/2022 2022 AmericanMedica l Association. tc;m1aIb Read this License Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. NCQA PCMH 2017 Standards Intro 3/29/18 4 A check-in will be conducted virtually online with an NCQA evaluator. 3 . NCQAs failure to exercise or enforce any right or power under this License Agreement shall not constitute a waiver of such right or power. 288 0 obj <> endobj y+,^ y{Ay|kd Y|E1/!s|_+Le{l|1gc0Ow. 4 0 obj 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. XIII. Official websites use .govA THIS LIMITED WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS, AND YOU MAY ALSO HAVE OTHER RIGHTS THAT VARY FROM JURISDICTION TO JURISDICTION. 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 This Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. The License is not transferable from Licensee to any other person, entity, organization or association. endstream endobj 1816 0 obj <>stream NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. Licensee agrees to maintain the Product in strict confidence and abide by all terms and conditions of this License Agreement. 59CNByOzdm You can decide how often to receive updates. JavaScript seems to be disabled in your browser. 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. 133 0 obj <>stream 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 https:// 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. 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. 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. Secure .gov websites use HTTPSA Upon accessing the Product, the Licensee is deemed to have accepted the license subject to the terms and conditions of this License Agreement. 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 JavaScript seems to be disabled in your browser. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. The 2020 HP Survey Tool was released on March 30, 2020. 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. EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2020 ONWARD. Hard copies of 2020 Health Plan Accreditation Standards and Guidelines available for purchase. We do not share your information with third parties. endobj 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. 3.0 : May 2019 . A Licensed User may not be an agent or consultant of a Licensee. and Scoring NCQA Requirements Additional NCQA Guidance ; PHM 2 Element A; To fully meet the criteria the organization must meet 3-7 factors. or 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. CMS contracted with NCQA to develop a strategy to evaluate the quality of care provided by SNPs. Save your favorite pages and receive notifications whenever theyre updated. ,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 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. V. OwnershipTitle to and full ownership of the Product belongs to NCQA. 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. 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. stream At this time, you can order: ePub: A downloadable PDF version of the standards Web-based: A license to access a web-based version of the standards through IRT Either of the above methods will give you immediate access to the standards. Anyone desiring broader internal distribution of the Product must purchase additional Licensed User permissions via the NCQA Store. NCQA sets standards for interpreting NCQA Accreditation standards and HEDIS measures. 4O?g{d~F&[EecTvH3=xbfU21vQ 8 57awmjUkP%N^H/I[d 8h,jsqQ'PFp&gjFo 0oN/wOptE"oKx Uawh/.S >t 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. <> 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. 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. Licensee may need additional software to use the Product, and NCQA is not responsible for such additional software. Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. 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 NCQA makes updates or clarifications to Standards & Guidelines several times per year, as needed. No license to reproduce, distribute or incorporate the HEDIS VSDs into any product is granted to Licensee by virtue of this License Agreement. 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). 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 established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. SNPs reported the following measures in HEDIS 2016: Please see the links below for the most recent SNP HEDIS Reports released by NCQA. You will be prompted to log in to your NCQA account. Data allow identification of performance gaps and establishment of realistic targets for improvement. Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. NCQA Utilization Management Accreditation is designed to ensure that organizations can consistently make appropriate and timely decisions. tC7J%[ eP2kpkN(w,'l?l?~cSG&?huB[lxN_a{# lon1cfVy0; zk{ k%$hE%K)z).M]rHK |QlG'N|q6A,h$&' P Ppp &" G3(t@?RpbGE_P\z|=9 o'{x8cgI{UEIo@h|E B1|H_q9yErb42EO{sNH0' p-7GRE)B5#GkbK'@-N!O" 2hF2u\G'wM$hEUKb.]Vh>A6!AG. Ye96Zl%)b>eP|P%#vp\a8SnV6[we2|-VGU*Jx>nb~57u|,v%tySb?VFHnj[2O W*_ XI. A Licensed User may not be an agent or consultant of a Licensee. Sign up to get the latest information about your choice of CMS topics. 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. $D4H)i0W`r~/30RDg`: q lock 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). endstream endobj 289 0 obj <> endobj 290 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Type/Page>> endobj 291 0 obj <>stream Constitute a waiver of such right or power used in this paragraph shall include all computer systems ; software ;... For the most recent SNP HEDIS Reports released by NCQA please see the links below for the number of Users. 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