Measures using the ECDS reporting method must be audited before being approved for use in a NCQA program. Measures in the HEDIS domain that use the ECDS reporting method have not yet been approved for use in any NCQA program at this time.
HEDIS 2018
FAQ Directory: HEDIS
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10.15.2017 ECDS Must measures be audited for public reporting, or may unaudited data be reported?
10.15.2017 ECDS How do vendors get the ECDS technical specifications for the submission file format?
HEDIS ECDS technical specifications are available in the NCQA store in PDF format: http://store.ncqa.org/index.php/catalog/product/view/id/2822/s/hedis-2018-volume-2-measures-for-electronic-clinical-data-systems/. They are also available in HEDIS 2018 Technical Specifications for Health Plans, which can be purchased at the NCQA store.
Complete digital measure packages for HEDIS ECDS measures will be available for download at a future date.
HEDIS 2018
10.15.2017 ECDS How do EHR vendors submit data and to whom does the submission file go?
Only health plans may submit HEDIS ECDS measure data to NCQA. EHR vendors should work with plans that use their systems to provide data that will be used to calculate HEDIS ECDS measures.
NCQA is currently certifying EHR vendors, to increase the reliability of health IT data used for reporting health care performance. Learn more at:
HEDIS 2018
10.15.2017 ECDS Who determines that data “qualify” for ECDS reporting?
Refer to the ECDS general guidelines for information. Request clarification through the NCQA Policy Clarification Support (PCS) system at https://my.ncqa.org or review the proposed systems with your NCQA-Certified auditor. Send requests for individual technical support with ECDS reporting to ecds@ncqa.org.
HEDIS 2018
10.15.2017 ECDS Are there standard guidelines for how an auditor determines and approves an ECDS database and the amount of provider accessibility needed?
There are no specific ECDS guidelines for auditor approval of ECDS data sources. Data sources must meet the ECDS requirements and must be reputable—containing accurate, complete and reliable clinical data. Auditors use the same validation methods as for all other data sources. For example, for claims data, auditors validate the accuracy and completeness of the plan’s claims data. For a case management system, auditors review the system, the processes for capturing data and whether data can be extracted from the system. NCQA will add guidance to audit requirements as we learn more about data sources being used.
HEDIS 2018
10.15.2017 ECDS For IP-ECDS coverage, does NCQA look for the number of members in the initial population?
IP-ECDS coverage count includes all members in the initial population who are being managed by at least one provider with the capacity to send, receive and use electronic data for quality improvement purposes.The Initial Population includes all members (covered and not covered by ECDS) who are identified as eligible for the measure reported by the data source category used to determine eligibility.
HEDIS 2018
9.15.2017 Transitions of Care Are Special Needs Plans (SNPs) and Medicare-Medicaid Plans (MMPs) required to report the Transitions of Care (TRC) measure?
8.15.2017 Breast Cancer Screening, Colorectal Cancer Screening, Controlling High Blood Pressure, and Osteoporosis Management in Women Who Had a Fracture A required exclusion was added to the Medicare product line for members 65 years of age and older living long-term in institutional settings for the Breast Cancer Screening, Colorectal Cancer Screening, Controlling High Blood Pressure and Osteoporosis Management in Women Who Had a Fracture measures. In addition to using the Medicare monthly membership file, may organizations use other data sources when identifying members living long-term in an institution?
No. Organizations may not use other data sources (e.g., supplemental or medical record data) when excluding members living long-term in an institution. The LTI flag in the Medicare Part C monthly membership file is the only source that may be used to identify this exclusion. NCQA was informed by CMS that all Medicare plans receive this file monthly and have access to this flag. NCQA plans to clarify this in the HEDIS 2018, Volume 2 Technical Update Memo, scheduled for release on October 2, 2017.
HEDIS 2018
8.15.2017 Use of Opioids From Multiple Providers The Use of Opioids From Multiple Providers (UOP) measure instructs organizations to use the National Provider Identifier (NPI) when identifying prescribers and pharmacies. How should organizations report pharmacy claims for opioids when the prescribing provider and/or pharmacy NPI is missing?
If the prescriber and/or pharmacy NPI is missing, count each dispensing event with a missing NPI as a different prescriber and/or different pharmacy when reporting the measure. NCQA plans to clarify this in the HEDIS 2018, Volume 2 Technical Update Memo, scheduled for release on October 2, 2017.
HEDIS 2018
4.14.2017 Controlling High Blood Pressure Please clarify the instruction to not include BP readings taken on the same day as a diagnostic test or procedure that requires a change in diet or medication. Must the change in diet or medication be required by the procedure? Is the BP eligible if a patient forgets to take their regular medication the day of a procedure? Is the BP eligible if the member receives a vaccine, a nebulizer treatment with albuterol or lidocaine injected prior to an unplanned removal of a small mole?
The intent is to identify diagnostic or therapeutic procedures that require a medication regimen, a change in diet or a change in medication. For example, colonoscopy requires a change in diet (NPO on the day of procedure) and a medication change (a medication is taken to prep the colon). Dialysis, infusions and chemotherapy are all therapeutic procedures that require a medication regimen. A nebulizer treatment with albuterol is considered a therapeutic procedure that requires a medication regimen (the albuterol). Injection of lidocaine prior to mole removal is considered a diagnostic procedure (if the mole is being tested) or a therapeutic procedure (if removal of the mole is the treatment) that requires a change in medication (lidocaine administered for pain control during the procedure). A patient forgetting to take regular medications on the day of the procedure is not considered a required change in medication, and therefore the BP reading is eligible.
A BP taken on the same day that the patient receives a vaccination is eligible for use. A vaccination is considered preventive medicine and is not considered a therapeutic or diagnostic procedure.
HEDIS 2017
4.14.2017 Comprehensive Diabetes Care Please clarify the instruction to not include BP readings taken on the same day as a diagnostic test or procedure that requires a change in diet or medication. Must the change in diet or medication be required by the procedure? Is the BP eligible if a patient forgets to take their regular medication the day of a procedure? Is the BP eligible if the member receives a vaccine, a nebulizer treatment with albuterol or lidocaine injected prior to an unplanned removal of a small mole?
The intent is to identify diagnostic or therapeutic procedures that require a medication regimen, a change in diet or a change in medication. For example, colonoscopy requires a change in diet (NPO on the day of procedure) and a medication change (a medication is taken to prep the colon). Dialysis, infusions and chemotherapy are all therapeutic procedures that require a medication regimen. A nebulizer treatment with albuterol is considered a therapeutic procedure that requires a medication regimen (the albuterol). Injection of lidocaine prior to mole removal is considered a diagnostic procedure (if the mole is being tested) or a therapeutic procedure (if removal of the mole is the treatment) that requires a change in medication (lidocaine administered for pain control during the procedure). A patient forgetting to take regular medications on the day of the procedure is not considered a required change in medication, and therefore the BP reading is eligible.
A BP taken on the same day that the patient receives a vaccination is eligible for use. A vaccination is considered preventive medicine and is not considered a therapeutic or diagnostic procedure.
HEDIS 2017
2.15.2017 Standardized Healthcare-Associated Infection Ratio When reporting the columns “Percentage of Total Discharges From Hospitals With Unavailable SIR,” “Number of Contracted Hospitals With Reportable SIR” and “Total Inpatient Discharges” in Table HAI-1/2/3, if a hospital is not listed in Table HSIR, is it included in the count?
Hospitals for which plans have discharges from but are not identifiable in Table HSIR should not be included in the hospitals reported in the category "Number of Contracted Hospitals With Reportable SIR." However, discharges from these hospitals should be included in “Total Inpatient Discharges” and in “Percentage of Total Discharges From Hospitals With Unavailable SIR.” Use Table HSIR posted on the NCQA Web site to make the determination; organizations do not need to refer to the Hospital Compare web site.
HEDIS 2017
