FAQ Directory: HEDIS

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7.16.2012 Medical Record Review Validation Have the criteria for determining a unique medical record process changed?

No. If the MRR processwhich includes training, tools, interrater reliability checks, rater-to-standard tests and any other quality control processis different by plan, product or product line, the auditor must conduct separate MRRV for each process by following the new validation steps.

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