Yes. Supplemental data may be used to identify race and ethnicity when stratifying the eligible population.
HEDIS MY 2022
FAQ Directory: HEDIS
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9.15.2021 General Guideline 33: Race and Ethnicity Stratification May supplemental data be used for race and ethnicity stratifications?
9.15.2021 PCS Questions Do answers from the Policy Clarification Support system have an expiration date?
9.15.2021 Well-Child Visits in the First 30 Months of Life (W30) Does a well child visit with an OB/GYN meet criteria for the W30 measure?
9.15.2021 Guidelines for Calculations and Sampling: Hybrid Method How should the eligible population be reported for hybrid measures if there are optional or required exclusions?
The eligible population for hybrid measures should be reported before the optional exclusions and after the required exclusions for all three hybrid method approaches (refer to Appendix 4 in HEDIS Volume 2). For example, if the eligible population is 100 members and 10 members met optional exclusion criteria, then the reported eligible population value must still be 100.
HEDIS MY 2022
9.15.2021 Guidelines for Calculations and Sampling: Hybrid Method How should the eligible population be reported for hybrid measures if there are optional or required exclusions?
The eligible population for hybrid measures should be reported before the optional exclusions and after the required exclusions for all three hybrid method approaches (refer to Appendix 4 in HEDIS Volume 2). For example, if the eligible population is 100 members and 10 members met optional exclusion criteria, then the reported eligible population value must still be 100.
HEDIS MY 2021
9.15.2021 Acute Hospital Utilization, Emergency Department Utilization and Hospitalization for Potentially Preventable Complications When should rounding occur for variance calculations?
The variance should not be rounded until the final step in the calculation. The final variance calculation for reporting should be rounded to four decimal places using the .5 rule. For example, the PPD and PUCD values are truncated to 10 decimal places, multiplied together at the member level and summed across members for the total. Round the total sum to four decimal places.
HEDIS MY 2021
7.15.2021 Colorectal Cancer Screening (COL) On May 18, 2021 the U.S. Preventive Services Task Force (USPSTF) updated the colorectal cancer screening recommendations to screen for colorectal cancer in adults aged 45 to 49 years. Will NCQA update the COL measure to coincide with the USPSTF recommendations that lower the screening age to 45? If yes, what HEDIS year can we expect this change to be reflected in the measure specs?
NCQA is aware of updates to the US Preventive Services Task Force (USPSTF) guidelines for colorectal cancer screening. Given these updates, NCQA will evaluate potential changes to the HEDIS Colorectal Cancer Screening (COL) measure through input from our clinical and technical measurement advisory panels, the Committee on Performance Measurement and public comment. Any potential changes to the measure resulting from this evaluation would be included in the HEDIS MY 2022 Technical Update at the earliest.
HEDIS MY 2021
6.15.2021 General Guideline 31 Is data from a certified eCQM vendor considered standard supplemental data?
No. NCQA released a policy change in July 2020 stating that certified QRDA I files are not considered standard supplemental data for HEDIS® reporting in 2022 for HEDIS MY 2021. Because of the dual HEDIS publication, HEDIS MY 2021 Volume 2 did not account for this policy change, but it will be reflected in HEDIS MY 2022 Volume 2. However, this FAQ is a reminder the policy changed in July 2020 and therefore must be followed. Organizations should work with their auditor to have this data validated as nonstandard supplemental data.
HEDIS MY 2021
4.15.2021 Antidepressant Medication Management (AMM) For Effective Continuation Phase Treatment, how many days are counted in the 232-day interval if a prescription of a 90-days supply is dispensed on the 151st day?
4.15.2021 Persistence of Beta-Blocker Treatment After a Heart Attack (PBH) How many days are counted in the 180-day interval if a prescription of 90 days supply is dispensed on the 100th day?
1.15.2021 Transitions of Care (TRC) Volume 2 states that for MY 2021 reporting, the organization may reduce the sample size using the prior year’s audited, product line-specific rate. Which rate should organizations use for sample size reduction?
1.15.2021 General Guideline 15 When a member has dual enrollment in Medicaid/Medicare how long must the member be enrolled in Medicare (PFFS or primary Medicare enrollment in another organization) to be removed from the Medicaid product line?
There is no minimum enrollment requirement. Per General Guideline 15, members must meet the measure’s continuous enrollment requirements and be considered dually enrolled based on continuous enrollment criteria or the service date.
Organizations must follow General Guideline 15 with regard to assessing coverage and should review enough data to meet the measure specification requirement.
HEDIS MY 2021