FAQ Directory: HEDIS

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9.15.2022 Follow-Up After Emergency Department Visit for Substance Use (FUA) Should the Residential Program Detoxification Value Set be used when reporting the FUA measure? It is not listed in the Value Set Directory.

Yes. The Residential Program Detoxification Value Set and codes will be included in the Update release of the Value Set Directory on March 31, 2023. The OID for the value set is 2.16.840.1.113883.3.464.1004.2408, and it includes two HCPCS codes:

  • H0010     Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) (H0010)
  • H0011   Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) (H0011)

HEDIS MY 2023

9.15.2022 Quality Compass License Agreement How can we determine if the Quality Compass license agreement meets my needs?

The standard license agreement for Quality Compass allows internal or external reporting for 15 measure indicators, 20 health plan submissions and 2 benchmarks (averages and/or percentiles) outside of the users licensed on the account. If your organization’s expected data usage does not align with the standard agreement, we can review your requested permissions and draft a customized agreement, subject to a different fee structure.
 

HEDIS MY 2021

9.15.2022 Publicly Reported Plans in Quality Compass How do I know what plans publicly reported data to NCQA? How do I know what measures will be reported in Quality Compass?

To obtain a list of health plan submissions and/or measures publicly reported in Quality Compass for a specific reporting year, contact the Information Products team by submitting your question on my.ncqa.org.
Quality Compass contains HEDIS and CAHPS measures that were eligible for publicly reporting during the measurement year. First year HEDIS measure results are not publicly reported in the tool.
 

HEDIS MY 2022

9.15.2022 Purchase Order Number Will NCQA accept a purchase order number?

Purchase order numbers may be included for payment and tracking purposes; however, NCQA does not accept additional terms and conditions outside the executed legal agreement. Any and all purchase order terms and conditions have no legal effect and the license is governed solely by the terms of the executed agreement between your entity and NCQA.
 

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.
 

HEDIS MY 2021

9.15.2022 Quality Compass Data Usage Update What if my data usage needs change after purchasing Quality Compass?

You can contact the Information Products team for assistance in expanding your permissions to meet your data usage needs. This includes any changes to the amount of data being shared (number of indicators) and how/with who the data is being shared with (internally for quality analysis purposes, external reporting on a brochure, email broadcast, website, blog) or commercial use of the data.
 

HEDIS MY 2021

9.15.2022 Quality Compass Appearance Prior to Purchasing How can I see what Quality Compass looks like prior to purchase?

You can experience Quality Compass’ functionality by watching the demo videos available on the Quality Compass webpage (https://www.ncqa.org/programs/data-and-information-technology/data-purchase-and-licensing/quality-compass/). The demo videos walks viewers through some of the key features of Quality Compass as well as how to navigate the tool.

You can also request a walk-through live demo from the Information Products team. Please submit your request through your my.NCQA.org account or contact NCQA’s Customer Support team.
 

HEDIS MY 2022

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.

HEDIS MY 2023

9.15.2022 PCS Questions Do answers from the Policy Clarification Support system have an expiration date?

We recommend that organizations not use PCS responses that are over 3 years old. If a question relates directly to a measure specification or a general guideline that was revised from a previous measurement year, you should resubmit the question.

HEDIS MY 2023

9.15.2022 Follow-Up Care for Children Prescribed ADHD Medication (ADD) In step 1 of the Event/Diagnosis for Rate 1, what timeframe is used to identify dispensed ADHD medications?

In step 1 identify all children in the specified age range who were dispensed an ADHD medication during the 12-month Intake Period. This clarification will be in the MY 2023 Technical Update.

HEDIS MY 2023

9.15.2022 Oral Evaluation, Dental Services (OED) The OED measure references the NUCC Provider Taxonomy Value Set to identify dental providers. Is this correct?

No. Replace “NUCC Provider Taxonomy Value Set” with “Dental Provider Value Set.” This correction will be in the MY 2023 Technical Update.

HEDIS MY 2023

9.15.2022 Social Need Screening and Intervention (SNS-E) For SNS-E, are organizations allowed to count screenings that were conducted using adapted or translated versions of screening instruments?

As an ECDS-reported measure, the SNS-E screening numerator counts only screenings that use instruments in the measure specification as identified by the associated LOINC code(s). Allowed screening instruments and LOINC codes for each social need domain are listed in “Definitions” in the measure specification.

NCQA recognizes that organizations might need to adapt or modify instruments to meet the needs of their membership. To clarify:

  • The SNS-E measure specification does not prohibit cultural adaptations or linguistic translations from being counted toward the measure’s screening numerators.
  • Only screenings documented using the LOINC codes specified in the SNS-E measure count toward the measure’s screening numerators.
  • The Regenstrief Institute, which maintains the LOINC database, has indicated that LOINC codes do not distinguish between adapted and translated instruments.
  • Tool developers have varying policies with regard to cultural adaptation and translations; some state that users may adapt screening instruments, others state that organizations must obtain permission first.

NCQA urges organizations to refer to the tool developer for information about adaptations or translations that are available or allowed.

HEDIS MY 2023