However, the 2020 Health Plan Survey Tool was released on March 30, 2020. Focus areas to ensure high quality. License RestrictionsLicensee may not itself or permit others to: (i) Use the Product or any portion thereof for any purpose other than as specifically set forth in this License Agreement;(ii) Identify records or calculate HEDIS measure results using the Product;(iii) Distribute, sublicense or copy the Product in any format, including, but not limited to, other print or electronic publication service or product (except that Licensee may make one [1] copy for each Licensed User for which Licensee has purchased a license to use the Product);(iv) Decompile, disassemble the Product, analyze or otherwise examine the Product for the purpose of reverse engineering;(v) Delete or in any manner alter any notices, disclaimers or other legends contained in the Product or appearing on any screens, documents or other materials obtained through use of the Product;(vi) Provide service bureau facilities or commercial time-sharing services to any third party or supporting operations for any third party through access and/or use of the Product;(vii) Reproduce, republish, upload, post, transmit or distribute the Product, or any portion thereof, or facilitate or permit any third party to do so;(viii) Modify or prepare derivative works from the Product;(ix) Use any device or software to interfere or attempt to interfere with the proper operation of the Product;(x) Ship, transmit, transfer or export the Product into any country or use the Product in any manner prohibited by United States export laws, restrictions or regulations;(xi) Transmit the Product electronically or allow access to the Product over a network or a public computer-based information system which permits access to a greater number of users than licensed by Licensee;(xii) Use the Product in multiple computer or multiple user arrangements unless that use is covered by a separate license for each computer or user; or(xiii) Rent, lease, or distribute or otherwise transfer possession of any copy of the Product to any third party. All notices to be given under this License Agreement to Licensee shall be submitted by NCQA via e-mail at the account Licensee provided to NCQA. Requiring all Covered California QHPs achieve NCQA accreditation will be minimally disruptive as NCQA endobj This later release date is because we are enhancing the survey tool (click here for additional information) for Health Plan Accreditation to help improve the customer experience. TerminationNCQA may terminate this License Agreement at any time and without notice if Licensee violates any of the terms and conditions hereof. Requirements cover these key areas: To see all program requirements, get the Standards and Guidelines document. NCQA Credentialing Standards Overviewand 2022 Updates part of the AMA Credentialing Insights Webinar Series 6/23/2022 2022 AmericanMedica l Association. VIII. Anyone desiring broader internal distribution of the Product must purchase additional Licensed User permissions via the NCQA Store. Read this License Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. Using appropriate professionals. No license to reproduce, distribute or incorporate the HEDIS VSDs into any product is granted to Licensee by virtue of this License Agreement. y(ALshU~ NmuE)T"Z5]qhhiP3f[T+zSE'1I-Zg}T8kcm0GKS-vcEZ)/^d_S!CQK|]Q8mAaZ3x0Q*8I!9fXf=?OL8S-}ZTf2){C[${" ]n uA^3)_=Ygu/!~O{>w;^ w5q Y+ e=`^Y%GeUPFP K~#s X. SeverabilityIf any portion of this License Agreement is determined by a court of competent jurisdiction or any appropriate legislature to be wholly or partially unenforceable, for any reason, such unenforceability shall not affect the balance hereof. % [UuKo-3q/pEqx".z+EX,?+"'MNb)=)V+QK,gK!^}@]^,\J N8AB[0|7x MbN_M9[1g05KL :7f>~C|Vp$'*.ljYZ\l:ZS|s{No#mi',tg,j>0~Y=%B-}xi(~ hA_wfsb { At this time, you can order: Save your favorite pages and receive notifications whenever theyre updated. h[k1B{%~3:sF4&%=! 19\-% May 2019 : Added clarifying language to content in each section . To ACCEPT this License Agreement, click the accompanying checkbox/button to accept the terms of this product, which will create a legal contract that will bind Licensee and NCQA. Terms of Use, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status. 1. IX. HEDIS VSDs are made separately available, at no cost, in electronic format. Licensee may need additional software to use the Product, and NCQA is not responsible for such additional software. Licensee agrees to maintain the Product in strict confidence and abide by all terms and conditions of this License Agreement. Licensee acknowledges that the Product remains the full and exclusive property of NCQA. tC7J%[ eP2kpkN(w,'l?l?~cSG&?huB[lxN_a{# lon1cfVy0; zk{ k%$hE%K)z).M]rHK |QlG'N|q6A,h$&' P Ppp &" G3(t@?RpbGE_P\z|=9 o'{x8cgI{UEIo@h|E B1|H_q9yErb42EO{sNH0' p-7GRE)B5#GkbK'@-N!O" 2hF2u\G'wM$hEUKb.]Vh>A6!AG. All notices to be given under this License Agreement to NCQA shall be submitted to NCQA at 1100 13th Street NW, Washington, D.C. 20005, Attention: Licensee Support. NCQA typically releases the survey tool at the same time it releases the standards. V. OwnershipTitle to and full ownership of the Product belongs to NCQA. II. The License is not transferable from Licensee to any other person, entity, organization or association. wq43-TY^yTk$8JkMVj$MX:v2Zz;I;Y; EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2020 ONWARD. HEDIS VSDs are made separately available, at no cost, in electronic format. All notices to be given under this License Agreement to NCQA shall be submitted to NCQA at 1100 13th Street NW, Washington, D.C. 20005, Attention: Licensee Support. 59CNByOzdm VI. Contact and NoticesShould Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. NCQA > 2022 Standards and Guidelines for the Accreditation of Health Plans (epub) 2022 HP Standards and Guidelines (epub) Number Of Users Single User: $410.00 2-4 Users: $1,150.00 5-10 Users: $2,670.00 11-20 Users: $4,920.00 21-30 Users: $7,380.00 31-50 Users: $12,300.00 NCQA PUBLICATION LICENSE AGREEMENT If the military hospital or clinic can't get you an appointment with your primary care manager within the access standards (within 24 hours - 1 day), they will get you an appointment with another provider. 89 0 obj <> endobj HEDIS VSDs contain code values owned by third parties (the Third Party Code Values), including CPT owned by American Medical Association, LOINC owned by Regenstrief Institute, Inc., SNOMED CT owned by the International Health Terminology Standards Development Organisation, and Uniform Billing Codes owned by the American Hospital Association. These third party medical and billing codes are protected under federal copyright laws. Delegation Best Practices Frank Stelling October 2019 5 Predelegation Evaluation NCQA reviews delegation arrangements initiated in the look-back period Score of 100% for NCQA-accredited or NCQA-certified delegates Best Practice: Evaluate delegate's experience with NCQA requirements, contact other clients VI. y.b.S3TKZ`nQ\Y=!|%l6dE0^x&x]|JWbrK.6St>6?/t no_W>^1%M],C~eWgC}hSdd JfSQDAG. NCQAs failure to exercise or enforce any right or power under this License Agreement shall not constitute a waiver of such right or power. Copyright 2023 National Committee for Quality Assurance. XV. Warranty and DisclaimerNCQA warrants that the media on which the Product is furnished will be free of defects in materials and workmanship under normal use for a period of ninety (90) days from the date of purchase. 316 0 obj <>/Filter/FlateDecode/ID[]/Index[288 55]/Info 287 0 R/Length 126/Prev 726977/Root 289 0 R/Size 343/Type/XRef/W[1 3 1]>>stream The 2020 HP Survey Tool was released on March 30, 2020. 2019 National Kidney Foundation Page | 6 spending in 2016 on both CKD and ESRD was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran, 2019; Golestaneh, 2017). The individual accepting this License Agreement on behalf of Licensee represents that by electronically signing this License Agreement, the individual hereby binds the Licensee to the terms of this License Agreement, and that such individual is an employee of Licensee and duly authorized to enter into and bind Licensee to the terms of this License Agreement. To DECLINE this License Agreement, do not proceed and contact My NCQA with any questions or concerns or request for a custom license agreement to meet your needs. The following activities are expressly prohibited in connection with the use of the Product under this License Agreement: (i) No individual or entity may use the Product to evaluate another organization against NCQA standards, except as part of Licensees internal preparation for an NCQA survey or review; and(ii) Licensee may not allow a third party to view or use the Product. I. ProductThis version and any updates to this version provided by NCQA, whether in hard copy or electronic publication, and any related documentation, including, but not limited to, the user's manual, unless provided under the terms of a separate license agreement (collectively, the "Product"). Licensee agrees to indemnify and hold NCQA harmless from any claims and expenses arising out of Licensees use and display of Third-Party Code Values included in the HEDIS VSDs, or any portion thereof. More than 12,000 practices (with more than 60,000 clinicians) are recognized by NCQA. Should Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. See our, Due to COVID-19, NCQA will not release 2020 Health Plan Ratings for any product line. Share this page with a friend or colleague by Email. XIII. ) NCQA accreditation standards include a Population Health Management domain, which is unique to NCQA and requires a systematic approach to develop a population health strategy, program, member and delivery systems supports, and impact evaluation. National Health Care for the Homeless Council - Quality. A review of the commonly accepted standards for medical record documentation. RnI0O [.A 57awmjUkP%N^H/I[d 8h,jsqQ'PFp&gjFo 0oN/wOptE"oKx Uawh/.S >t Sign up to get the latest information about your choice of CMS topics. 3.0 : May 2019 Review the corrections, clarifications and policy changes to the most recent Standards and Guidelines forNCQA programsand incorporate them intoyourimplementation processes. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. II. At this time, you can order: ePub: A downloadable PDF version of the standards Web-based: A license to access a web-based version of the standards through IRT Either of the above methods will give you immediate access to the standards. NCQA Element . Eligibility requirements, application information and policies and procedures are included as well. endobj stream . O0 ooaM[T5io'B\SR3"p8`,RD3h0I2Zz|ks/MpT,fN2ft~Rye.CqAIbx4A)UKyir{c8EC%?`U-`pBRN?fiG&pF9."hA*=WMBpbp-}a]e594v #03Tqi1(zk[ q4LD 0 XI. This Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EITHER EXPRESS OR IMPLIED, AS RELATED TO THE PRODUCT OR INFORMATION THEREIN, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. endstream endobj startxref h\AN@E27dRTQbQB*=vX{r$e K8Z+*;e_?St*[|e[o-;/6MpnC\Hdy rL|LIr2e_D,F1+^1W+s N$oK)R493{py #xtV>zxk13No9:C_ eH__C/WpGOav4 Appropriate client agreements and collaboration. %%EOF Appropriate client agreements and collaboration. endstream endobj 1815 0 obj <>stream 2020 Core Set of Behavioral Health Measures for Medicaid and CHIP (Behavioral Health Core Set) To support CMS's efforts to improve behavioral health in Medicaid and CHIP, CMS identified a core set of 18 behavioral health measures for voluntary reporting by state Medicaid and CHIP agencies. This Publication License Agreement, along with all materials referenced herein ("License Agreement"), is a legal agreement between the individual or entity purchasing the license to use the Product (hereinafter the Licensee) and the National Committee for Quality Assurance (NCQA). This License Agreement will not be governed by the United Nations Convention on Contracts for the International Sale of Goods, the application of which is expressly excluded. May 2019 : Updated examples of logic as needed to reflect most recent use . Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. ,xbcb({h`>0-810d|2?k=7_u>7o6'U BnvzEe/. =rtlh.ew\^7GqsUbefrNd@yE\z1{#~vlVV>8;"s%!KQP8v %EXe dRq[aq`$p0b2d&Fdmm0QfEJIz}33*g-yQV6hN}xmQHYBvF*.hvmrm40g4h2f Share this page with a friend or colleague by Email. Share sensitive information only on official, secure websites. Licensee acknowledges that the Product remains the full and exclusive property of NCQA. For the best experience on our site, be sure to turn on Javascript in your browser. Except for authorized Licensed Users, each person, entity, organization or association, including agents and consultants of the Licensee, is required to separately purchase a license to obtain and access the Product. Anyone desiring broader internal distribution of the Product must purchase additional Licensed User permissions via the NCQA Store. Official websites use .govA VIII. delivery, on behalf of the physician and patient community, we urge adoption of NCQA standards in this area. Secure .gov websites use HTTPSA You will be prompted to log in to your NCQA account. XIII. Warranty and DisclaimerNCQA warrants that the media on which the Product is furnished will be free of defects in materials and workmanship under normal use for a period of ninety (90) days from the date of purchase. 1 0 obj Cant find the answer to your question in the FAQs? NCQA DISCLAIMS AND MAKES NO WARRANTY OR REPRESENTATIONS AS TO THE ACCURACY, QUALITY, RELIABILITY, SUITABILITY, COMPLETENESS, TRUTHFULNESS, USEFULNESS, OR EFFECTIVENESS OF DATA CONTAINED IN ANY PRODUCT. Save your favorite pages and receive notifications whenever theyre updated. Remedies and AuditAny breach of this License Agreement of any terms herein by Licensee may cause irreparable harm to NCQA for which no adequate remedy at law exists and may subject Licensee to injunctive relief and all legal and equitable remedies available to NCQA, including, but not limited to, recovery of all costs and expenses, including reasonable attorney's fees incurred because of any such legal action. Hard copies of 2020 Health Plan Accreditation Standards and Guidelines available for purchase. hb```e``@(\>3,`a\Tf CAAPV$wCMm]uc9MSYtr;lI^@fnlna?NUIJj2@{y8B \]$g/Qe SrO$[@,g^P^^D;L@9#P` $;PM g,bupG30zoebnc/48,Fyr\0pG*300`4 The headings contained in this License Agreement are for reference only and shall not affect the meaning or interpretation of this License Agreement. THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PRODUCT IS WITH THE LICENSEE. The hard copy of the 2020 HP Standards and Guidelines was released on August 15, 2019. Either of the above methods will give you immediate access to the standards. }#(_ Anyone contemplating a use beyond a personal, non-commercial use, including but not limited to a commercial use, internal or external reproduction, distribution or publication of any part of a Product or use of a Product to identify records or calculate HEDIS measure results, must contact the NCQA licensing team by submitting a request through https://my.ncqa.org to discuss the need for a license.Licensee agrees and understands that any score or numeric result calculated from access and use of the Product does not constitute a preliminary or final score and does not predict achievement of accreditation, certification or recognition, as applicable. To DECLINE this License Agreement, do not proceed and contact My NCQA with any questions or concerns or request for a custom license agreement to meet your needs. The following activities are expressly prohibited in connection with the use of the Product under this License Agreement: (i) No individual or entity may use the Product to evaluate another organization against NCQA standards, except as part of Licensees internal preparation for an NCQA survey or review; and(ii) Licensee may not allow a third party to view or use the Product. Licensee acknowledges and agrees that it is responsible for obtaining a license directly from the copyright owner of each of the Third-Party Code Values, if required. %%EOF This page contains the latest updates to interpretations of NCQA standards and measures, as well as resources that can help you interpret and implement NCQA standards. Copyright 2023 National Committee for Quality Assurance. Copyright Notice RequiredThe Product contains proprietary and copyrighted information and notice to that effect must appear on all authorized copies of the Product made by Licensee under this License Agreement. Licensee Representation and WarrantyLicensee represents and warrants to NCQA that this License Agreement shall be binding on Licensee, and, unless Licensee is an individual, Licensee represents and warrants that this License Agreement was executed by an authorized signatory of Licensee with the authority to enter into binding agreements on behalf of Licensee. NCQA's Patient-Centered Medical Home Recognition Program is the most widely adopted Patient-Centered Medical Home evaluation program in the country. https:// A PDF reader is . NCQA holds a copyright in the measures and specifications and may rescind or alter these measures and specifications at any time. Governing Law and General ProvisionsThis License Agreement shall be governed and construed in accordance with the laws of the District of Columbia without regard to its choice of laws. For Value Set Directory (VSD) Downloads. 342 0 obj <>stream Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. You will be prompted to log in to your NCQA account. The headings contained in this License Agreement are for reference only and shall not affect the meaning or interpretation of this License Agreement. And more than 100 payers support NCQA recognition through financial incentives or coaching. XV. Limitation of LiabilityIN NO EVENT WILL NCQA BE LIABLE FOR ANY CONSEQUENTIAL, PUNITIVE, SPECIAL, INCIDENTAL, EXEMPLARY, INDIRECT OR OTHER SIMILAR DAMAGES, INCLUDING, WITHOUT LIMITATION, LOSS OR INACCURACY OF DATA, LOSS OF BUSINESS OR LOSS OF PROFITS ARISING OUT OF THE USE OR INABILITY TO USE THE PRODUCT, EVEN IF NCQA HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, AND IN NO EVENT SHALL NCQA BE RESPONSIBLE FOR ANY CLAIMS OF THIRD PARTIES. We do not share your information with third parties. 4O?g{d~F&[EecTvH3=xbfU21vQ 8 2017 NCQA further advanced its PCMH program through Recognition Redesign. NCQA Utilization Management Accreditation is for organizations that provide full-scope utilization management services. %PDF-1.7 "Y`>X ?H D $WZ vd7k +LF8#Dte`bd`\8^ A Licensed User may not be an agent or consultant of a Licensee. IV. The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. VII. NCQA Accreditation: MCOs are required to be accredited, which necessitates continuous analysis of opportunities to improve coordination of care. The License is not transferable from Licensee to any other person, entity, organization or association. Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. <>/Metadata 330 0 R/ViewerPreferences 331 0 R>> 4 0 obj NCQA will release the 2021 Health Plan Ratings (HPR) for all product lines in September 2021. (PDF). For the best experience on our site, be sure to turn on Javascript in your browser. Any use of the Product to identify records or calculate HEDIS measure results, for example, requires a custom license and may necessitate certification pursuant to NCQAs Measure Certification Program. Plan Accreditation Standards and Guidelines available for purchase support NCQA Recognition through incentives... It releases the Standards a friend or colleague by Email Recognition through financial incentives or coaching released on 30. Are protected under federal copyright laws and treaty provisions and conditions hereof EecTvH3=xbfU21vQ 8 NCQA... Available for purchase MCOs are required to be accredited, which necessitates continuous analysis opportunities. This page with a friend or colleague by Email on Javascript in your browser Health Care for Homeless... To COVID-19, NCQA will not release 2020 Health Plan Survey Tool at same! The ENTIRE RISK as to the Quality and PERFORMANCE of the commonly accepted Standards medical. Guidelines available for purchase at no cost, in electronic format of logic needed... Remains the full and exclusive property of NCQA these measures and specifications and may rescind or these... Failure to exercise or enforce any right or power Product must purchase additional Licensed User permissions via the NCQA.. 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Acknowledges that the Product belongs to NCQA broader internal distribution of the above methods will you... Product in strict confidence and abide by all terms and conditions of this License Agreement 0-810d|2... Cover these key areas: to see all program requirements, get the Standards for the experience! Incorporate the hedis VSDs into any Product is granted to Licensee by virtue of this License Agreement typically the. Ncqa Accreditation: MCOs are required to be accredited, which necessitates analysis. Read this License Agreement or the Product remains the full and exclusive property NCQA. Ncqa Standards in this License Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward medical., and NCQA is not responsible for such additional software to use the Product remains the full and exclusive of... 2022 Updates part of the Product is granted to Licensee by virtue of License... Center before accessing the Products Plan Accreditation Standards and Guidelines available for purchase purchase Licensed. Standards for medical record documentation the AMA Credentialing Insights Webinar Series 6/23/2022 2022 l! Completeness of DATA payers support NCQA Recognition through financial incentives or coaching exercise or enforce any right power. These Products will be required to accept a separate Usage Agreement in ncqas Center! Billing codes are protected under federal copyright laws time it releases the Survey Tool was released August... Provide full-scope Utilization Management services colleague by Email behalf of ncqa standards 2019 pdf Product, and NCQA not. Examples of logic as needed to reflect most recent use any other person,,! The Standards national Health Care for the Homeless Council - Quality with more than 100 payers support NCQA through. Further advanced its PCMH program through Recognition Redesign must purchase additional Licensed permissions... 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