The continuous enrollment should be the measurement year and the year prior to the measurement year. This will be corrected in the MY 2013 version of the P4P manual.
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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4.16.2013 Adult BMI Assessment (ABA) The specifications state that ABA is the same measure as the CMS Stars measure Adult BMI assessment, which uses the HEDIS specification. The HEDIS specification defines continuous enrollment as the measurement year and the year prior, but the IHA specification defines continuous enrollment as only the measurement year. Which is the correct continuous enrollment?
4.16.2013 Asthma Medication Ration (AMR) Table AMR-C includes the drug Indacteral, but this drug is not the final ASM-C NDC table. Should Indacteral be included in the measure?
No. Indacteral was removed from the ASM-C NDC list and noted in a Word document posted with the NDC lists on November 2, 2012. The medication was reviewed by the HEDIS Expert Pharmacy Panel and determined to be not indicated for asthma, so it was removed from the measure. The MY 2013 P4P manual will reflect this change.
4.16.2013 Diabetes Care (CDC) The following note appears to be listed under the Optimal Diabetes Care indicator for CDC: Additional exclusion criteria are required for this indicate that will results in a different eligible population from all other indicators. What are the additional criteria for the Optimal Diabetes Care indicator?
4.15.2013 Scoring for CR 2, Element C: Agreement and Collaboration with Health Plans How is CR 2, Element C scored for organizations that may not have a delegation agreement in place?
4.15.2013 Look-back period for delegation agreements and pre-delegation assessments of Interim Eos What is the look-back period for delegation agreements and predelegation evaluations for organizations coming through for Interim Surveys?
4.15.2013 Delegating to an entity out of the country Does NCQA allow organizations to delegate to entities that are outside the United States and its territories?
4.15.2013 Scoring for CRC 2, Element C: Agreement and Collaboration with Health Plans How is CRC 2, Element C scored for organizations that may not have a delegation agreement in place?
3.16.2013 Encounter Rate by Service Type (ENRST) Table ENR-F in the Encounter Rate by Service Type measure has instructions to download codes from the CMS Web site, but the referenced file is no longer on the site. The instructions refer specifically to a spreadsheet titled Addendum AA-ASC Covered Surgical Procedures (ASC_AddAA.csv) for October 2012 from the site http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/11_Addenda_Updates.html
When I click the link, it brings up a download file named "asc-october2012-aa-bb-dd1-dd2-ee.zip," which has an excel spreadsheet and 5 txt files, ASC AA, ASC BB (and so on). Are these correct? Which should we use?
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.