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4.15.2026 Calendar year data for calculating UM rates For HPA UM 1, Elements B-H, are organizations required to calculate 12 months of continuous data from the survey submission date?

No. Organizations must use 12 months of continuous data and may use data from the most recent calendar year (e.g., January 1–December 31). The workbook must be completed at least once during the look-back period.

Applicable standards:

Health Plan Accreditation: UM 1, Elements B-H.
Behavioral Health Accreditation: UM 1, Elements B-F.
Utilization Management Accreditation: UM 3, Elements B-H.

This applies to the following Programs and Years:

HP 2026|UM 2026|BHA 2026