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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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12.11.2014 General Guidelines: Supplemental Data The Supplemental Data section of the P4P General Guidelines no longer includes information about supplemental data portability between health plans and POs, but there is still a note referring to this policy under general guideline #49. Are plans allowed to use audited PO supplemental data?

You are correct, the sections about supplemental data portability were removed from the December release of the MY 2014 P4P Manual, but they should be reinstated.
The section under the “Supplemental Data Timeline” on page 26 of the MY 2014 P4P Manual should read:
P4P Health plans that use audited PO supplemental data should receive the audited data files and audit results from the PO by the April deadline listed in the P4P Data Collection and Reporting timeline. The health plan should receive all supporting documents for each supplemental data source (e.g., Roadmap section, file layouts, training materials, [PSV samples], etc.,) at the time the Roadmap is submitted to the auditor. The PO is responsible for sending the health plan all necessary documentation to support the use of supplemental data.

The note under “Identifying and Validating Supplemental Data” on page 27 of the MY 2014 P4P Manual should read:
Note: Only health plans that participate in the P4P program can use audited PO supplemental data for their P4P and HEDIS data submissions. The PO must provide the health plan with a completed Roadmap section for each supplemental data source, all applicable attachments, the auditor’s review findings and PSV results. The P4P health plans are not required to also collect the proof-of-service documents for these audited and approved PO data. (see P4P Audit Review Guidelines, released in November 2014).

And the following Activity or Milestone and deadline should be added to the “P4P Data Collection and Reporting Timeline” on page 8 of the MY 2014 P4P Manual.
 

Supplemental Data to Health Plans: P4P Health plans receive the audited supplemental data files and audit results from the PO.April 15, 2015

 
Please also note, that although this policy is applicable to MY 2014, NCQA is currently reviewing many policies for P4P and HEDIS reporting; we expect to reassess these guidelines and others for MY 2015.

ALL 2014