FAQ Directory: HEDIS

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7.16.2012 Medical Record Review Validation Why was a new statistical test chosen for MRRV?

The new test will reduce the number of errors allowed in the systematic sample collected using the Hybrid Method. Auditors will use the Squeglia Zero-based Sampling Plan, which includes more measures but has a smaller sample of 16 charts.

HEDIS 2013

7.16.2012 Medical Record Review Validation Does NCQA expect a decrease in rates with this new policy?

Although NCQA does not anticipate that rates will decrease, plans will need to start early and collect all data by May 15 to ensure that their rates are not affected.

HEDIS 2013

8.19.2022 Long-Term Services and Supports Shared Care Plan With Primary Care Practitioner (LTSS-SCP) For MY2022 reporting, should members without a care plan (or with a partial care plan) be excluded from the LTSS-SCP measure?

No. For MY2022 reporting, members without a care plan (or with a partial care plan) should not be excluded from the LTSS-SCP measure. These members would remain in the measure and would be numerator non-compliant.

HEDIS_LTSS MY 2022

3.28.2022 RAND Table for LTSS MY 2022 For LTSS MY 2022 reporting, the random number for sampling members for the Long-Term Services and Supports Shared Care Plan With Primary Care Practitioner (LTSS-SCP) is “0.59”; it is “0.58” for Long-Term Services and Supports Comprehensive Assessment and Update (LTSS-CAU) and Long-Term Services and Supports Comprehensive Care Plan and Update (LTSS-CPU). Should all three measures have the same RAND?

Yes. The RAND should be “0.58” for LTSS-SCP, LTSS-CAU and LTSS-CPU for HEDIS LTSS MY 2022 reporting.

HEDIS_LTSS MY 2022