Element C is scored "NA" for organizations that do not have a delegation agreement, and there is no reporting to the client.
UM-CR 2013
Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can ask a question through My NCQA.
From the site http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/11_Addenda_Updates.html, select the link October 2012 ASC Approved HCPCS Code and Payment Rates and use the text file AA. This will be corrected in the next release of the P4P manual.
Yes. As long as the member can receive the information or complete the listed activities in the element in one attempt or contact, a Web chat will meet the requirements. The organization would need to provide documentation explaining how the system works and evidence of completion of the specified actions.
If a member has two separate 90+ day enrollment periods during the measurement year, each with a pharmacy benefit, exclude the member due to a gap in enrollment.
If a member has two separate enrollment periods, one for fewer than 90 days, include the member in the measure but count only the 90+ day enrollment period. Use the date of disenrollment from the 90+ day enrollment period as the end of the measurement period.
If a member has two separate enrollment periods, one with no pharmacy benefit, include the member in the measure but count only the enrollment with the pharmacy benefit. Use the date of disenrollment from the enrollment period with the pharmacy benefit as the end of the measurement period.
No. Documentation is required for 5% of PCPs/EPs reported as using certified software, but the same PCP/EP may be used for every measure. For example, the following scenarios are acceptable documentation: