View Table of Contents for this Publication. 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. 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. 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. THE LIMITATIONS OF DAMAGES AND LIABILITIES SET FORTH IN THIS LICENSE AGREEMENT ARE FUNDAMENTAL ELEMENTS OF THE BASIS OF THE BARGAIN BETWEEN NCQA AND LICENSEE, AND THE PRICING FOR THE LICENSE REFLECTS SUCH LIMITATIONS. <> As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. VII. NCQA Utilization Management Accreditation is designed to ensure that organizations can consistently make appropriate and timely decisions. NCQA makes updates or clarifications to Standards & Guidelines several times per year, as needed. IV. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. %PDF-1.7 XVII. VII. Copyright 2023 National Committee for Quality Assurance. 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. XV. SNPs can use HEDIS performance data to identify opportunities for improvement, monitor the success of quality improvement initiatives, track improvement, and provide a set of measurement standards that allow comparison with other plans. Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. 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. AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. Copyright 2023 National Committee for Quality Assurance. 3 0 obj V. OwnershipTitle to and full ownership of the Product belongs to NCQA. Contact and NoticesShould Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. And more than 100 payers support NCQA recognition through financial incentives or coaching. XII. 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). ,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 IV. 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Changes to NCQA Accreditation and Certification Standards for 2018 and 2019 (June 26, 2018) Modifying NCQA Requirements in Response to Hurricanes and other Natural Disasters (September 7, 2017) Utilization Management: Changes to UM 4, Appropriate Classification of Denials; the Future of Utilization Management (July 31, 2017) 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. G'a8 z ,hI:0` Mdm9V@ Licensee may need additional software to use the Product, and NCQA is not responsible for such additional software. 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. y.b.S3TKZ`nQ\Y=!|%l6dE0^x&x]|JWbrK.6St>6?/t no_W>^1%M],C~eWgC}hSdd JfSQDAG. <>/Metadata 330 0 R/ViewerPreferences 331 0 R>> The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. tc;m1aIb 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. 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). NCQA Utilization Management Accreditation is for organizations that provide full-scope utilization management services. For the best experience on our site, be sure to turn on Javascript in your browser. Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA.To verify compliance with this License Agreement, NCQA is granted the right, with prior notice and during normal business hours, to examine all relevant records of Licensee. The Product is being licensed (not sold) to you, the Licensee (the License). . View Table of Contents for this Publication. 288 0 obj <> endobj % SurvivalThe provisions of Sections V, VII and VIII of this License Agreement shall survive the termination of this License Agreement. May 2019 : Added clarifying language to content in each section . Upon termination of this License Agreement, all rights under this License Agreement, including the license granted to Licensee, will cease. Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. Data allow identification of performance gaps and establishment of realistic targets for improvement. 2019 National Kidney Foundation Page | 6 spending in 2016 on both CKD and ESRD was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran, 2019; Golestaneh, 2017). This License Agreement may not be modified by Licensee except upon mutual agreement by the parties in writing, signed by an authorized representative of NCQA. A Licensed User may not be an agent or consultant of a Licensee. NCQAs failure to exercise or enforce any right or power under this License Agreement shall not constitute a waiver of such right or power. tC7J%[ eP2kpkN(w,'l?l?~cSG&?huB[lxN_a{# lon1cfVy0; zk{ k%$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. Upon accessing the Product, the Licensee is deemed to have accepted the license subject to the terms and conditions of this License Agreement. ( THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PRODUCT IS WITH THE LICENSEE. <> Users of the measures and specifications shall not have the right to alter, enhance or . XVI. 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. XI. Share sensitive information only on official, secure websites. 0 `mdm:"d5mauw4a]`}+\#6'M OqMR xwF9{]X]oMq#G2|d;aVWW=x s.M0bY4BIub0h2`Lot 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. All uses of these Third-Party Code Values may require a license from the copyright owner. Start with . For Value Set Directory (VSD) Downloads. 4O?g{d~F&[EecTvH3=xbfU21vQ 8 endstream endobj startxref 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. tG+~zM~8j 0 ( II. 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 ]'SEWf?7'yh]u&fmk9x2:-.SH,nE}u9Ecn+i+`e)+uL,x u]M37?0BgQ1GyF7px` 16!Xb.$74"C)i^Y. 133 0 obj <>stream Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. 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. 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"). 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. ModificationsThis License Agreement is the complete and exclusive statement of the agreement between Licensee and NCQA, and supersedes any proposal or prior agreement, oral or written, and any other communications between the parties relating to the subject matter of this License Agreement. endobj May 2019 : Updated examples of logic as needed to reflect most recent use . Licensed Users mean Licensees employees who may access and use the Product on behalf of the Licensee. endstream endobj 289 0 obj <> endobj 290 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Type/Page>> endobj 291 0 obj <>stream 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 Case Management publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. 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. THE USE OF THE DATA WITHIN ANY PRODUCT IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. ePub and web-based licenses for 2020 Health Plan Accreditation Standards and Guidelines available for purchase. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 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. NCQA PCMH 2017 Standards Intro 3/29/18 4 A check-in will be conducted virtually online with an NCQA evaluator. Y)d&BZ$C#t0iT_Dy/D: `byhB7;)*RD )EEB "{*(Ah=AMYh& ZY@T.YKVu. 2017 NCQA further advanced its PCMH program through Recognition Redesign. A review of the commonly accepted standards for medical record documentation. Unauthorized internal distribution of the Product and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 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