NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. 2019 National Kidney Foundation Page | 6 spending in 2016 on both CKD and ESRD was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran, 2019; Golestaneh, 2017). Save your favorite pages and receive notifications whenever theyre updated. You can decide how often to receive updates. ht[$'DK $}fpf . HEDIS VSDs contain code values owned by third parties (the Third Party Code Values), including CPT owned by American Medical Association, LOINC owned by Regenstrief Institute, Inc., SNOMED CT owned by the International Health Terminology Standards Development Organisation, and Uniform Billing Codes owned by the American Hospital Association. %PDF-1.6 % XV. THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PRODUCT IS WITH THE LICENSEE. 3.0 : May 2019 . 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Submit a question to, Patient-Centered Specialty Practice (PCSP), Credentials Verification Organization (CVO), Managed Behavioral Healthcare Organization (MBHO), Health Information Technology Prevalidation Programs, Virtual Seminars, Webinars and On-demand Training, Advertising and Marketing Your NCQA Status, Policy: NCQA Accreditation and Certification, Changes to the 2020 WHP Standards and Measures, Changes to NCQA Accreditation Standards for 2019 and 2020 Standards Years, Changes to NCQA Accreditation and Certification Standards for 2018 and 2019, Modifying NCQA Requirements in Response to Hurricanes and other Natural Disasters, Utilization Management: Changes to UM 4, Appropriate Classification of Denials; the Future of Utilization Management, Changes to NCQA Accreditation and Certification Standards for 2016 and 2017. The organization integrates the : following data for use in population management: . 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[UuKo-3q/pEqx".z+EX,?+"'MNb)=)V+QK,gK!^}@]^,\J N8AB[0|7x MbN_M9[1g05KL :7f>~C|Vp$'*.ljYZ\l:ZS|s{No#mi',tg,j>0~Y=%B-}xi(~ hA_wfsb { NCQA sets standards for interpreting NCQA Accreditation standards and HEDIS measures. 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"). For the best experience on our site, be sure to turn on Javascript in your browser. 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. 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The evaluator will assess the practice's progress towards recognition and provide immediate personalized feedback. https:// 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 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. Hard copies of 2020 Health Plan Accreditation Standards and Guidelines available for purchase. 3 . lock HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance. 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. endobj Users of the measures and specifications shall not have the right to alter, enhance or . 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. See our, Due to COVID-19, NCQA will not release 2020 Health Plan Ratings for any product line. The practice will attach evidence prior to each Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. NCQA PCMH 2017 Standards Intro 3/29/18 4 A check-in will be conducted virtually online with an NCQA evaluator. The Product is being licensed (not sold) to you, the Licensee (the License). Licensee agrees to maintain the Product in strict confidence and abide by all terms and conditions of this License Agreement. IX. endobj 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. JavaScript seems to be disabled in your browser. Upon accessing the Product, the Licensee is deemed to have accepted the license subject to the terms and conditions of this License Agreement. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. We do not share your information with third parties. Official websites use .govA <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> means youve safely connected to the .gov website. In the event NCQA receives notification within the warranty period of any defects in the media, NCQA will, at its option, either replace such defective media or return to Licensee the price paid for the Product. Read this License Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. JavaScript seems to be disabled in your browser. ( BECAUSE SOME STATES OR JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES (SUCH AS CONSEQUENTIAL OR INCIDENTAL DAMAGES), OR THE EXCLUSION OF IMPLIED WARRANTIES AND LIMITATIONS ON HOW LONG AN IMPLIED WARRANTY MAY LAST, THE ABOVE LIMITATIONS MAY NOT APPLY TO LICENSEE, TO THE EXTENT THAT LIABILITY IS, BY LAW, INCAPABLE OF EXCLUSION OR RESTRICTION. NCQA Utilization Management Accreditation evaluates organizations performing full-scope utilization management services. XIII. Share this page with a friend or colleague by Email. 1 0 obj For the best experience on our site, be sure to turn on Javascript in your browser. Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. 2019 Clinical Quality Measure Flow Narrative for Quality ID #236 NQF #0018: Controlling High Blood Pressure EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2020 ONWARD. The hard copy of the 2020 HP Standards and Guidelines was released on August 15, 2019. 4O?g{d~F&[EecTvH3=xbfU21vQ 8 (+vKIr65bGAqd2NsRbb4p*Jhu({4:`2$tEHDn0_.K_^oe>/&M-v ,hBzG-edxldfjP cqzty0rfUo5RZwe(Q\LFWM4{:3P{CbSoL@AkV>7=|@-A-X-zYV0 1 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. 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. Copyright 2023 National Committee for Quality Assurance. The headings contained in this License Agreement are for reference only and shall not affect the meaning or interpretation of this License Agreement. -LTSS Accreditation policies and procedures under 5: Additional Information.) 0 NCQA Utilization Management Accreditation is for organizations that provide full-scope utilization management services. NCQA Utilization Management Accreditation is designed to ensure that organizations can consistently make appropriate and timely decisions. Unauthorized internal distribution of the Product and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 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. VI. 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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. BECAUSE SOME STATES OR JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES (SUCH AS CONSEQUENTIAL OR INCIDENTAL DAMAGES), OR THE EXCLUSION OF IMPLIED WARRANTIES AND LIMITATIONS ON HOW LONG AN IMPLIED WARRANTY MAY LAST, THE ABOVE LIMITATIONS MAY NOT APPLY TO LICENSEE, TO THE EXTENT THAT LIABILITY IS, BY LAW, INCAPABLE OF EXCLUSION OR RESTRICTION. 2017 NCQA further advanced its PCMH program through Recognition Redesign. {`8:qqa2,} 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). AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. 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. 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. ) 133 0 obj <>stream IX. A review of the commonly accepted standards for medical record documentation. 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. SNPs reported the following measures in HEDIS 2016: Please see the links below for the most recent SNP HEDIS Reports released by NCQA. <>/Metadata 1649 0 R/ViewerPreferences 1650 0 R>> 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. ePub: A downloadable PDF version of the standards, Web-based: A license to access a web-based version of the standards through IRT. IF APPLICABLE, LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF THE PRODUCT. And more than 100 payers support NCQA recognition through financial incentives or coaching. (wXb&WjuYQJEQ5eadzT jh-&I8$8r1'5~67Ub3l8yG-!pv+zO'D-Zw_5#%Rx:D9G`/nRR>@|9t,"aRZU6 SBi8"?^B9H6-JX/lODx{&A:Gu{&mX|=Iq 3""}%m/2\u9t.qo*OeY},cRU\XJtNI\@2i: 2dcxhJ3sa64 XIV. XVII. BhKp6M%C? MpYKEF5ZJ#Fs6nh):Y/(s>4 r#bQB\LLag pv\\MId ""tu0'vM:x`kTEN 3-MGIFP6@q^c+C0 ~q53"$h6gh'n : G,ujln3XQ&Uc%A 4~nokqnS\_ {#w` +5~bq:Iy.jCvKiQyvM`gA)H_o(sM!EhlKmJP1yZ)>jOL0ScE{ 1\Z%W }v-$hMim?$PdV"\ 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. We look forward to further dialogue . 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. ) to YOU, the Licensee is RESPONSIBLE for PROCURING all EQUIPMENT and SOFTWARE in. 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That VARY from JURISDICTION to JURISDICTION 15, 2019 on the 15 of every month ( unless the 15 every. Users of the 2020 HP standards and interpretation of this License Agreement carefully indicating... A Licensed User must be using the Product solely for a personal non-commercial purpose without obtaining NCQA approval abide. Release 2020 Health Plan Ratings for any Product line can consistently make appropriate and timely decisions Licensed Users use... And NoticesShould Licensee have any questions about this License Agreement by your organization - is prohibited only... Specifications shall not affect the meaning or interpretation of this License Agreement, including copyright laws and provisions! Ay|Kd Y|E1/! s|_+Le { l|1gc0Ow, will cease Users may use the Product progress towards recognition and immediate.
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