FAQ Directory

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.

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9.15.2022 Quality Compass Data Extract What if I only need access to a subset of the data from Quality Compass? Can I obtain a data extract?

If you do not need access to all the data results available within Quality Compass, you can request a custom data extract. Pricing for data extracts start at $2,500 and are determined by the amount of data requested and the client’s use case.

You can obtain a custom quote by reaching out to the Information Products team and completing a data request form that details your data needs and requested permissions.
 

This applies to the following Programs and Years:
HEDIS MY 2021

9.15.2022 Quality Compass Access When will I receive access to Quality Compass?

Access to the data is granted as soon as payment is received by check or credit card.

The default email address used for access will be the individual’s whose information was included under the “Ship To” section completed at checkout Login and password information will be emailed to the default user after NCQA sets up the account. The default user, also known as the Administrative User, will have access to manage the additional licensed users on the account.

 

This applies to the following Programs and Years:
HEDIS MY 2021

9.15.2022 Purchasing Quality Compass How do I purchase Quality Compass?

If you are purchasing Quality Compass directly from the NCQA Store and your organization does not require a custom license agreement, you can simply visit the NCQA Store page to complete your purchase.
If you require a custom data license agreement and have accepted the quote provided by the Information Products (IP) team, the next step is to have a customized agreement forwarded to you for the organization’s review and signature. The customized agreement will include information on the permissions, data usage and fees discussed with the IP department.

Once the agreement is signed by both parties, NCQA will issue an invoice for payment. Once payment is received, you will be granted access to the data and/or the agreed upon permissions take effect.
 

This applies to the following Programs and Years:
HEDIS MY 2021

9.15.2022 Use of future dates to verify education and training Are future dates acceptable for verifying education and training?

No. NCQA does not accept future dates of program completion as valid verification of completion of education and training.

This applies to the following Programs and Years:
HP 2022|MBHO 2022|UM-CR-PN 2022|CVO 2022

9.15.2022 Cost to Purchase Quality Compass How much does Quality Compass cost?

Quality Compass is priced according to the number of users, years of trended data, and whether your organization needs access to the Data Exporter feature. The cost breakdown is available on our pricing table on the NCQA Store .
 

This applies to the following Programs and Years:
HEDIS MY 2021

9.15.2022 Race/Ethnicity Diversity of Membership (RDM) The RDM measure references General Guideline 31: Race and Ethnicity Stratification, but the MY 2023 Value Set Directory does not list race/ethnicity value sets or direct reference codes. Are these used when reporting the RDM measure?

Yes. Use the race/ethnicity value sets and direct reference codes in Tables RES-C-1/2/3 and RES-D-1/2/3 (in General Guideline 31) to report the RDM measure. This clarification will be in the MY 2023 Technical Update.

This applies to the following Programs and Years:
HEDIS MY 2023

9.15.2022 General Guideline 32: Medicare Socioeconomic Status Stratification Which measures does General Guideline 32: Medicare Socioeconomic Status Stratification apply to?

The Hemoglobin A1c Control for Patients With Diabetes measure should be removed from the measure list. The Plan All-Cause Readmissions measure should be added to the list. This clarification will be in the MY 2023 Technical Update.

This applies to the following Programs and Years:
HEDIS MY 2023

9.15.2022 Audit Timeline The HEDIS MY 2022 Audit Timeline posted on NCQA’s website states that organizations must submit all documentation, including Sections 5 and 5a of the Roadmap, by March 1. Does this mean that organizations have until March 1 to submit Sections 5 and 5a?

No. The Roadmap is due January 31. All sections must be submitted by this date. The “March 1” date for Sections 5 and 5a is meant to account for the rare occasion where a supplemental data source is identified after the January 31 deadline and must be considered for audit. These sources must be identified no later than March 1, with a completed Roadmap section. This should be the exception, not the standard process.

This applies to the following Programs and Years:
HEDIS MY 2022

9.15.2022 Antibiotic Utilization for Respiratory Conditions (AXR) The Antibiotic Utilization for Respiratory Conditions (AXR) does not include age stratifications and total rate bullets. Was this intentional?

No. A correction will be in the MY 2023 Technical Update. The Ages section in the Eligible Population should read as follows:
Members who were 3 months of age or older as of the Episode Date. Report three age stratifications and a total rate:

  • 3 months–17 years.
  • 18–64 years.
  • 65 years and older.
  • Total.

The total is the sum of the age stratifications.

This applies to the following Programs and Years:
HEDIS MY 2023

9.15.2022 Backdating effective dates Can an organization backdate an effective date for a practitioner to the practitioner’s start date in the network?

NCQA requires organizations to credential practitioners before they provide care to members. NCQA uses the date of the Credentialing Committee or medical director’s decision (in the case of clean files) to determine credentialing timeliness requirements.

This applies to the following Programs and Years:
HP 2022|MBHO 2022|UM-CR-PN 2022|CVO 2022

9.15.2022 Quality Compass Sharing Restrictions What are the sharing restrictions and guidelines for distributing the data available on Quality Compass?

You can find the standard guidelines and restrictions for data usage in Section 2 of the Quality Compass license agreement. This agreement in located on our website as well as on the NCQA store site, prior to any purchase of a license. If you expect your data usage to fall outside of the permissions set forth in the standard agreement, NCQA offers customized agreements to grant extended permissions and use cases, subject to a separate fee.

If you are unsure if your use case falls outside the standard license terms, submit your question via my.ncqa.org for further assistance.
 

This applies to the following Programs and Years:
HEDIS MY 2021

9.15.2022 Quality Compass Release Dates 2022 What are the release dates for the Quality Compass 2022(MY2021) product lines?

The expected release dates for Quality Compass 2022(MY2021) are as follows:

    • Commercial – July 29th, 2022
    • Medicaid – September 30th, 2022
    • Medicare – October 28th, 2022
    • Exchange – November 2022 

This applies to the following Programs and Years:
HEDIS MY 2021