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FAQ Directory: HEDIS

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7.16.2012 Medical Record Review Validation Has NCQA communicated the changes to the MRRV process?

Yes. We sent communication to plans, auditors, vendors, physician groups, purchaser groups and state and federal agencies.

HEDIS 2013

7.16.2012 Medical Record Review Validation Does the audit timeline have a new MRR completion date?

Yes. For HEDIS 2013, NCQA will enforce a medical record review deadline of May 15 (the previous deadline was May 10). No charts will be accepted past this deadline, when auditors will begin to review records. Holding all plans to the same timeline ensures comparability among submissions.

HEDIS 2013

7.16.2012 Medical Record Review Validation How can we prepare for the changes listed in the MRRV memo?

Communicate timeline changes and processes to staff; to your network of providers; to leadership at your plan; to medical record and copy vendors; and to your software vendor. Develop a plan and prepare with adequate resources for the HEDIS season. Add HEDIS performance guarantees with vendors to ensure clear understanding of goals and timelines.

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