Unauthorized internal distribution of the Product and materials therein - beyond the number of Licensed Users by your organization - is prohibited. 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. And more than 100 payers support NCQA recognition through financial incentives or coaching. The timing is flexible and up to the practice to determine. The Product is being licensed (not sold) to you, the Licensee (the License). 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. Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. 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. NCQA holds a copyright in the measures and specifications and may rescind or alter these measures and specifications at any time. These third party medical and billing codes are protected under federal copyright laws. N 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 \bMQ!HQd2`/_$EFcGI'.mG_|qxcB3XLf. Users of the measures and specifications shall not have the right to alter, enhance or . 3.0 : May 2019 . Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. <>/Metadata 330 0 R/ViewerPreferences 331 0 R>> x #-;g'bI&Z$@DD*.-;7Wu:orWm\|~uQmx! VIII. 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. %%EOF Anyone desiring broader internal distribution of the Product must purchase additional Licensed User permissions via the NCQA Store. <> The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. 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. @Xn^xJps Share this page with a friend or colleague by Email. NCQA will release the 2021 Health Plan Ratings (HPR) for all product lines in September 2021. See our. 2019 Clinical Quality Measure Flow Narrative for Quality ID #236 NQF #0018: Controlling High Blood Pressure NCQA's PCMH program is the largest, with more than 65,000 cliniciansabout 18 percent of all primary care cliniciansat 14,000 sites as of June 2018. Fully meets Criteria 3.A. 0 As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. . 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. We anticipate, in 2019, further state legislative action to ensure health plans meet requisite standards for hospital-based physician network adequacy. XI. 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. New FAQs are posted on the 15 of every month(unless the 15 falls on a weekend). 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Healthcare Effectiveness Data and Information Set (HEDIS), Chronic Condition Special Needs Plans (C-SNPs), Dual Eligible Special Needs Plans (D-SNPs), Institutional Special Needs Plans (I-SNPs), Use of Spirometry Testing in the Assessment and Diagnosis of COPD, Pharmacotherapy Management of COPD Exacerbation, Persistence of Beta-Blocker Treatment After a Heart Attack, Annual Monitoring for Patients on Persistent Medications, Potentially Harmful Drug-Disease Interactions in the Elderly, Use of High-Risk Medications in the Elderly, Osteoporosis Management in Women Who Had a Fracture, Follow-Up After Hospitalization for Mental Illness. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. The headings contained in this License Agreement are for reference only and shall not affect the meaning or interpretation of this License Agreement. stream 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"). Hard copies of 2020 Health Plan Accreditation Standards and Guidelines available for purchase. Share sensitive information only on official, secure websites. Requirements cover these key areas: Applying an internal QI process. These third party medical and billing codes are protected under federal copyright laws. %PDF-1.7 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. or Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. A Licensed User must be using the Product under the License and solely on behalf of the Licensee. NCQA Utilization Management Accreditation is designed to ensure that organizations can consistently make appropriate and timely decisions. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. 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. XII. endobj Copyright 2023 National Committee for Quality Assurance. Terms of Use, Corrections, Clarifications and Policy Changes, New FAQs are posted on the 15 of every month, Cant find the answer to your question in the FAQs? %%EOF The organization integrates the : following data for use in population management: . The National Committee for Quality Assurance Patient-Centred Medical Home (NCQA-PCMH) is officially recognised as a quantitative assessment tool of institutional evaluation (supply-side) [ 9 ], and the PCAT is widely used as a quantitative assessment tool for patient evaluation (demand-side) [ 10 ]. 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: $12,300.00 NCQA PUBLICATION LICENSE AGREEMENT NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. NCQA Utilization Management Accreditation is for organizations that provide full-scope utilization management services. (+vKIr65bGAqd2NsRbb4p*Jhu({4:`2$tEHDn0_.K_^oe>/&M-v ,hBzG-edxldfjP cqzty0rfUo5RZwe(Q\LFWM4{:3P{CbSoL@AkV>7=|@-A-X-zYV0 1 ,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 $D4H)i0W`r~/30RDg`: q Upon termination of this License Agreement, all rights under this License Agreement, including the license granted to Licensee, will cease. 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. 2017 NCQA further advanced its PCMH program through Recognition Redesign. endstream endobj 1815 0 obj <>stream Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. IV. An official website of the United States government NCQA Utilization Management Accreditation is designed to ensure that organizations can consistently make appropriate and timely decisions. Licensee may need additional software to use the Product, and NCQA is not responsible for such additional software. XV. % VI. A PDF reader is . 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. Upon termination of this License Agreement, all rights under this License Agreement, including the license granted to Licensee, will cease. Appropriate client agreements and collaboration. SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF IMPLIED WARRANTIES OR LIMITATIONS ON HOW LONG IMPLIED WARRANTIES MAY LAST, SO THE ABOVE LIMITATIONS AND EXCLUSIONS MAY NOT APPLY TO YOU. 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"). At this time, you can order: Save your favorite pages and receive notifications whenever theyre updated. 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. 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. x]Hw=X}AG#>_K PhCIc;++v]I~}s[UdVLo>|*ne^ 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. TerminationNCQA may terminate this License Agreement at any time and without notice if Licensee violates any of the terms and conditions hereof. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. % 4 0 obj 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. Eligibility requirements, application information and policies and procedures are included as well. XI. lock THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PRODUCT IS WITH THE LICENSEE. PCMH Incentive: Primary care practices are offered a per- member per-month incentive to become recognized by NCQA as a PCMH, which necessitates quality improvement projects. endobj hV[o;+~l^[CE"6*`o]B&VfyT &b:@5fQ%D3f Q2A5&1?Z2LZ1%j[X$c|5h(C.c92 5Qlfb9w|UWl1w U9Ldd|V.hsGBt,Bu T#l+ Dv.E Zv?bkvir{~Y&m:S 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 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. Ye96Zl%)b>eP|P%#vp\a8SnV6[we2|-VGU*Jx>nb~57u|,v%tySb?VFHnj[2O W*_ Requirements cover these key areas: To see all program requirements, get the Standards and Guidelines document. Copyright 2023 National Committee for Quality Assurance. lock VII. 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 Health Plan Accreditation Standards and Guidelines were released on July 29, 2019. 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. View Table of Contents for this Publication. endstream endobj 90 0 obj <> endobj 91 0 obj <> endobj 92 0 obj <>stream 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. 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. 1 0 obj 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. 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