VIII. The License is not transferable from Licensee to any other person, entity, organization or association. Licensee agrees to maintain the Product in strict confidence and abide by all terms and conditions of this License Agreement. Hard copies of 2020 Health Plan Accreditation Standards and Guidelines available for purchase. Share this page with a friend or colleague by Email. [UuKo-3q/pEqx".z+EX,?+"'MNb)=)V+QK,gK!^}@]^,\J N8AB[0|7x MbN_M9[1g05KL :7f>~C|Vp$'*.ljYZ\l:ZS|s{No#mi',tg,j>0~Y=%B-}xi(~ hA_wfsb { For the best experience on our site, be sure to turn on Javascript in your browser. Licensee agrees to indemnify and hold NCQA harmless from any claims and expenses arising out of Licensees use and display of Third-Party Code Values included in the HEDIS VSDs, or any portion thereof. THIS LIMITED WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS, AND YOU MAY ALSO HAVE OTHER RIGHTS THAT VARY FROM JURISDICTION TO JURISDICTION. (+vKIr65bGAqd2NsRbb4p*Jhu({4:`2$tEHDn0_.K_^oe>/&M-v ,hBzG-edxldfjP cqzty0rfUo5RZwe(Q\LFWM4{:3P{CbSoL@AkV>7=|@-A-X-zYV0 1 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 DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. You will be prompted to log in to your NCQA account. May 2019 : Added clarifying language to content in each section . and Scoring NCQA Requirements Additional NCQA Guidance ; PHM 2 Element A; To fully meet the criteria the organization must meet 3-7 factors. 3 . 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. VI. 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. ,xbcb({h`>0-810d|2?k=7_u>7o6'U BnvzEe/. =rtlh.ew\^7GqsUbefrNd@yE\z1{#~vlVV>8;"s%!KQP8v %EXe dRq[aq`$p0b2d&Fdmm0QfEJIz}33*g-yQV6hN}xmQHYBvF*.hvmrm40g4h2f XII. Organizations must meet program criteria to pursue this accreditation. endobj All notices to be given under this License Agreement to Licensee shall be submitted by NCQA via e-mail at the account Licensee provided to NCQA. NCQA DISCLAIMS AND MAKES NO WARRANTY OR REPRESENTATIONS AS TO THE ACCURACY, QUALITY, RELIABILITY, SUITABILITY, COMPLETENESS, TRUTHFULNESS, USEFULNESS, OR EFFECTIVENESS OF DATA CONTAINED IN ANY PRODUCT. 2008 NCQA launched the first PCMH Recognition program, 2011/ 2014 NCQA raised the bar with updates to PCMH Recognition. hb```e``@(\>3,`a\Tf CAAPV$wCMm]uc9MSYtr;lI^@fnlna?NUIJj2@{y8B \]$g/Qe SrO$[@,g^P^^D;L@9#P` $;PM g,bupG30zoebnc/48,Fyr\0pG*300`4 0 1 0 obj h{koG_G X4!iIZHm*)yn`Pxq|f-gZ3^IU\E,V/pfs-Qjl2j %X2c>>/i1f2<5GBghj,em@?}as_o.]~wTv]p>]{w?/&F~tZyF0}#?mVononW?72PwglMU8:2_vT~wi?sv/ r[7VjQ^x|;X77nM|"zyu,pq?$Wg+[}ry$x?~6-n~]ts~V1Ww?\mvJBS |{i{sV~ ,'|^]+:Y>R>}/Z (m`3.bL,@VE~21"dm([P `[y~qx>*S:`iV81~RO/O.0] }x^P#rbriy+#B8},-5%(muE}wuk#;3#}?OyLrm4|8:p:w~|f:Nmr{G\x(]`u{^cU,N]v5L;FK/WD\oX{*9)Pb,Y%'8:VWD 2020 Health Plan Survey Tool released (with standards included). &eNA!$}(5I6KA"+D}Qt\V+Zs1eM6fz:srrhdkqJ)> *>ogVwIHL)xL\0BZb)Ct>#5L9VQSUHU?8.ttE3zVu8bq-&. 9.v h)f -2OJ v)TXS=p 8U&s$\m At this time, you can order: Save your favorite pages and receive notifications whenever theyre updated. License GrantNCQA hereby grants Licensee a personal, non-exclusive, non-transferable license to use the Product in accordance with the terms of this License Agreement. The 2020 Health Plan Accreditation Standards and Guidelines were released on July 29, 2019. The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. NCQA Credentialing Standards Overviewand 2022 Updates part of the AMA Credentialing Insights Webinar Series 6/23/2022 2022 AmericanMedica l Association. Updated language/content to align with standards changes : QDM 5.4 and CQL 1.3 . `mdm:"d5mauw4a]`}+\#6'M OqMR xwF9{]X]oMq#G2|d;aVWW=x s.M0bY4BIub0h2`Lot <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> hbbd```b``~"R 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). Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. XVII. 2017 NCQA further advanced its PCMH program through Recognition Redesign. Data allow identification of performance gaps and establishment of realistic targets for improvement. <>/Metadata 330 0 R/ViewerPreferences 331 0 R>> VII. You will be prompted to log in to your NCQA account. ePub and web-based licenses for 2020 Health Plan Accreditation Standards and Guidelines available for purchase. 120 0 obj <>/Filter/FlateDecode/ID[<48406E995A1F58F99F91F151A459A036><350766D18F74F749AC4CA79F5EEE2321>]/Index[89 45]/Info 88 0 R/Length 142/Prev 985545/Root 90 0 R/Size 134/Type/XRef/W[1 3 1]>>stream stream (wXb&WjuYQJEQ5eadzT jh-&I8$8r1'5~67Ub3l8yG-!pv+zO'D-Zw_5#%Rx:D9G`/nRR>@|9t,"aRZU6 SBi8"?^B9H6-JX/lODx{&A:Gu{&mX|=Iq 3""}%m/2\u9t.qo*OeY},cRU\XJtNI\@2i: 2dcxhJ3sa64 VIII. II. endobj Added additional examples of logic in each section to provide context : 3.0 . The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. Users must still click the I AGREE checkbox at the end of this License Agreement to access those Products, but the terms of this License Agreement will have no legal effect. endstream endobj 1815 0 obj <>stream 2019-Mar 2019-Jun 2019-Sep 2019-Dec 2020-Mar 2020-Jun 2020-Sep 2020-Dec 2021-Mar 2021-Jun 2021-Sep 2021-Dec . lock 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. Except as provided for in Section II above, Licensee has no, and is not granted, any right, title, interest or other license in the Product. Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. 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 Anyone desiring broader internal distribution of the Product must purchase additional Licensed User permissions via the NCQA Store. %%EOF Copyright 2023 National Committee for Quality Assurance. AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. 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. endstream endobj 1816 0 obj <>stream NCQA does not within the standards of our HIPAA Nothing included in NCQA standards are intended to conflict with an organization's responsibility to comply with l and state laws as it relates to privacy, security and confidentiality. Licensed Users mean Licensees employees who may access and use the Product on behalf of the Licensee. This publication features in-depth explanations and examples of how to meet the standards, accreditation scoring guidelines and points, accreditation outcomes and reporting categories. Sign up to get the latest information about your choice of CMS topics. We do not share your information with third parties. <> 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. Heres how you know. Appropriate client agreements and collaboration. XIII. 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. The hard copy of the 2020 HP Standards and Guidelines was released on August 15, 2019. 2019 Clinical Quality Measure Flow Narrative for Quality ID #50: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older Please refer to the specific section of the specification to identify the denominator and numerator information for use in submitting this Individual Specification. Health Insurance Plan Network Narrowing . JavaScript seems to be disabled in your browser. XVI. A Licensed User must be using the Product under the License and solely on behalf of the Licensee. For the best experience on our site, be sure to turn on Javascript in your browser. Access . G'a8 z ,hI:0` Mdm9V@ As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. Contact and Notices. THIS LIMITED WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS, AND YOU MAY ALSO HAVE OTHER RIGHTS THAT VARY FROM JURISDICTION TO JURISDICTION. 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. Focus areas to ensure high quality. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. x #-;g'bI&Z$@DD*.-;7Wu:orWm\|~uQmx! Eligibility requirements, application information and policies and procedures are also included. NOTE: This License Agreement is null and void as related to the following NCQA Products (as such term is defined in Section I below): Risk Adjustment Tables, HEDIS Medication List Directory and CA DHCS QIP (any) Edition of HEDIS Digital Measures Bundle For ECDS Reporting. %BX{^4.bygeB;GO 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. See our. 0 2'sYP'IeIFH5-st#,Z5v&*}"xC0!"#:#}?rjJS',#l2u)h3p+a:fRlA8E@9~fBa"=KQY(?\mq1)gg$\y#cvnG54h0'[#0YNdR8}2e. XI. THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PRODUCT IS WITH THE LICENSEE. 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 Specifications for the Medicare Health Outcomes Survey, Case Management (CM) and Long-Term Services and Supports (LTSS), Managed Behavioral Healthcare Organizations (MBHO), Utilization Management/Credentialing/Provider Network (UM/CR/PN), Credentials Verification Organizations (CVO), Patient-Centered Specialty Practice (PCSP), California Align Measure Perform (AMP) & Value Based Pay for Performance (VBP4P), Skip to the beginning of the images gallery. May 2019 : Updated examples of logic as needed to reflect most recent use . AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. Share this page with a friend or colleague by Email. IF APPLICABLE, LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF THE PRODUCT. CMS contracted with NCQA to develop a strategy to evaluate the quality of care provided by SNPs. y+,^ y{Ay|kd Y|E1/!s|_+Le{l|1gc0Ow. Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. 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. THE USE OF THE DATA WITHIN ANY PRODUCT IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PRODUCT IS WITH THE LICENSEE. }#(_ XVII. %PDF-1.6 % Eligible organizations: Note: Members refers to membership of clients and organizations. y.b.S3TKZ`nQ\Y=!|%l6dE0^x&x]|JWbrK.6St>6?/t no_W>^1%M],C~eWgC}hSdd JfSQDAG. And more than 100 payers support NCQA recognition through financial incentives or coaching. All other uses, including a commercial use (including but not limited to vendors or consultants using or embedding the measures and specifications and/or Value Set Directory into any product or service to calculate measure results or provide any measure-related service to customers for any purpose) and/or any internal or external reproduction, distribution or publication (including but not limited to federal and state entities using or incorporating the measures into their programs) must be approved by NCQA and are subject to a license at the discretion of NCQA. ePub: A downloadable PDF version of the standards, Web-based: A license to access a web-based version of the standards through IRT. 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"). This License Agreement may not be modified by Licensee except upon mutual agreement by the parties in writing, signed by an authorized representative of NCQA. IN NO EVENT WILL NCQA'S TOTAL LIABILITY FOR ANY DIRECT DAMAGES RESULTING FROM ANY CLAIMS, DEMANDS OR ACTIONS ARISING OUT OF OR RELATING TO THE PRODUCT OR ANY PART THEREOF, OR THIS LICENSE AGREEMENT, EXCEED THE PRICE PAID FOR THE PRODUCT, WHETHER SUCH LIABILITY ARISES FROM ANY CLAIM BASED ON CONTRACT, WARRANTY, TORT OR OTHERWISE. If any part of this License Agreement is found void and unenforceable, it will not affect the validity of the remainder of the License Agreement, which shall remain valid and enforceable according to its terms. (PDF). 342 0 obj <>stream NCQA typically releases the survey tool at the same time it releases the standards. Upon termination, Licensee agrees to immediately return to NCQA or destroy, at NCQAs option, all copies of the Product, together with any back-up copy, modifications and any merged portions, in any form, in Licensee's possession. 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. 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. NCQA or its licensors own all rights, title and interests in the Product, including trade secrets, patents, copyrights and database rights, and the Product shall remain the sole and exclusive property of NCQA (except as otherwise set forth below regarding third party copyright ownership of portions of HEDIS VSDs). A Licensed User may not be an agent or consultant of a Licensee. ht[$'DK $}fpf . NCQAs failure to exercise or enforce any right or power under this License Agreement shall not constitute a waiver of such right or power. 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. Share this page with a friend or colleague by Email. 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. Organizations must meet 3-7 factors to your NCQA account shall not assign this License Agreement shall not constitute waiver... This page with a friend or colleague by Email NCQA Recognition through financial incentives or coaching and treaty provisions 0-810d|2. Electronic books and records > VII changes: QDM 5.4 and CQL 1.3 RIGHTS THAT VARY FROM to. 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