Licensee agrees to maintain the Product in strict confidence and abide by all terms and conditions of this License Agreement. Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. @Xn^xJps [UuKo-3q/pEqx".z+EX,?+"'MNb)=)V+QK,gK!^}@]^,\J N8AB[0|7x MbN_M9[1g05KL :7f>~C|Vp$'*.ljYZ\l:ZS|s{No#mi',tg,j>0~Y=%B-}xi(~ hA_wfsb { XH> { ,lyDJ^ IjL`2LLX An explanation of the 8 and 30 file sampling procedure used by NCQA during accreditation survey visits. XIV. We do not share your information with third parties. ePub and web-based licenses for 2020 Health Plan Accreditation Standards and Guidelines available for purchase. Copyright 2023 National Committee for Quality Assurance. -LTSS Accreditation policies and procedures under 5: Additional Information.) <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> No license to reproduce, distribute or incorporate the HEDIS VSDs into any product is granted to Licensee by virtue of this License Agreement. h{koG_G X4!iIZHm*)yn`Pxq|f-gZ3^IU\E,V/pfs-Qjl2j %X2c>>/i1f2<5GBghj,em@?}as_o.]~wTv]p>]{w?/&F~tZyF0}#?mVononW?72PwglMU8:2_vT~wi?sv/ r[7VjQ^x|;X77nM|"zyu,pq?$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 The Product is being licensed (not sold) to you, the Licensee (the License). A Licensed User may not be an agent or consultant of a Licensee. 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. The License is not transferable from Licensee to any other person, entity, organization or association. % 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. website belongs to an official government organization in the United States. IX. Copyright 2023 National Committee for Quality Assurance. endobj An official website of the United States government Save your favorite pages and receive notifications whenever theyre updated. VIII. <> The 2020 Health Plan Accreditation Standards and Guidelines were released on July 29, 2019. 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. endstream endobj startxref 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. NCQA Utilization Management Accreditation is designed to ensure that organizations can consistently make appropriate and timely decisions. 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. For the best experience on our site, be sure to turn on Javascript in your browser. III. 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. EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2020 ONWARD. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. 3 0 obj 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. Upon accessing the Product, the Licensee is deemed to have accepted the license subject to the terms and conditions of this License Agreement. tG+~zM~8j 0 ( 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. 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. A review of the commonly accepted standards for medical record documentation. wq43-TY^yTk$8JkMVj$MX:v2Zz;I;Y; % 1 0 obj You will be prompted to log in to your NCQA account. <>/Metadata 1649 0 R/ViewerPreferences 1650 0 R>> endobj 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 89 0 obj <> endobj Focus areas to ensure high quality. National Health Care for the Homeless Council - Quality. hV[o;+~l^[CE"6*`o]B&VfyT &b:@5fQ%D3f Q2A5&1?Z2LZ1%j[X$c|5h(C.c92 5Qlfb9w|UWl1w U9Ldd|V.hsGBt,Bu T#l+ Dv.E Zv?bkvir{~Y&m:S RnI0O [.A 2F%At/|b^-x({N&R26y H4>1=.~MClx-ikqGbg NOTE: This License Agreement is null and void as related to the following NCQA Products (as such term is defined in Section I below): Risk Adjustment Tables, HEDIS Medication List Directory and CA DHCS QIP (any) Edition of HEDIS Digital Measures Bundle For ECDS Reporting. 0 c_G[~rsHQ@"#A@tiTh ~?Ioh*dVSo(*(.. XVII. JavaScript seems to be disabled in your browser. Licensee acknowledges and agrees that it is responsible for obtaining a license directly from the copyright owner of each of the Third-Party Code Values, if required. IN NO EVENT WILL NCQA'S TOTAL LIABILITY FOR ANY DIRECT DAMAGES RESULTING FROM ANY CLAIMS, DEMANDS OR ACTIONS ARISING OUT OF OR RELATING TO THE PRODUCT OR ANY PART THEREOF, OR THIS LICENSE AGREEMENT, EXCEED THE PRICE PAID FOR THE PRODUCT, WHETHER SUCH LIABILITY ARISES FROM ANY CLAIM BASED ON CONTRACT, WARRANTY, TORT OR OTHERWISE. tC7J%[ eP2kpkN(w,'l?l?~cSG&?huB[lxN_a{# lon1cfVy0; zk{ k%$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. 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. 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. &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 Eligibility requirements, application information and policies and procedures are included as well. Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. XVII. The standards are designed for organizations providing full-scope utilization management services that include the use of evidence-based criteria, relevant clinical information and qualified health professionals to make utilization management decisions. endstream endobj startxref Licensee means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the License Agreement terms below. 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 the best experience on our site, be sure to turn on Javascript in your browser. Eligible organizations: Note: Members refers to membership of clients and organizations. XI. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. 1 0 obj Unauthorized internal distribution of the Product and materials therein - beyond the number of Licensed Users by your organization - is prohibited. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. More than 12,000 practices (with more than 60,000 clinicians) are recognized by NCQA. NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. 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? THIS LIMITED WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS, AND YOU MAY ALSO HAVE OTHER RIGHTS THAT VARY FROM JURISDICTION TO JURISDICTION. The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. NCQAs failure to exercise or enforce any right or power under this License Agreement shall not constitute a waiver of such right or power. 11/25/2019 3:59:12 PM . 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. Licensed Users mean Licensees employees who may access and use the Product on behalf of the Licensee. 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. Heres how you know. NCQA Element . 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. 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. SurvivalThe provisions of Sections V, VII and VIII of this License Agreement shall survive the termination of this License Agreement. NCQAs failure to exercise or enforce any right or power under this License Agreement shall not constitute a waiver of such right or power. 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. Read this License Agreement carefully before indicating acceptance by clicking the associated checkbox/button and moving forward. NCQA maintains adatabase of frequently asked questionsabout NCQA standards and interpretation of requirements. 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. NCQA will release the 2021 Health Plan Ratings (HPR) for all product lines in September 2021. \bMQ!HQd2`/_$EFcGI'.mG_|qxcB3XLf. 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. 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. 0 You will be prompted to log in to your NCQA account. <> The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. 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. For the best experience on our site, be sure to turn on Javascript in your browser. NCQA PCMH 2017 Standards Intro 3/29/18 4 A check-in will be conducted virtually online with an NCQA evaluator. ( 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. G'a8 z ,hI:0` Mdm9V@ endobj We look forward to further dialogue . 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). %%EOF Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. And more than 100 payers support NCQA recognition through financial incentives or coaching. Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. XV. The headings contained in this License Agreement are for reference only and shall not affect the meaning or interpretation of this License Agreement. 288 0 obj <> endobj x]Hw=X}AG#>_K PhCIc;++v]I~}s[UdVLo>|*ne^ Should Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. 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. Share this page with a friend or colleague by Email. 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. Official websites use .govA 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. NCQA typically releases the survey tool at the same time it releases the standards. %BX{^4.bygeB;GO 2'sYP'IeIFH5-st#,Z5v&*}"xC0!"#:#}?rjJS',#l2u)h3p+a:fRlA8E@9~fBa"=KQY(?\mq1)gg$\y#cvnG54h0'[#0YNdR8}2e. 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. 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. 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"). VI. May 2019 : Added clarifying language to content in each section . All uses of these Third-Party Code Values may require a license from the copyright owner. Share this page with a friend or colleague by Email. 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 Contact and NoticesShould Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. As applicable, the Product is licensed for the number of Licensed Users for which a Licensee has paid the applicable fee. 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 Member confidentiality. For Value Set Directory (VSD) Downloads. The headings contained in this License Agreement are for reference only and shall not affect the meaning or interpretation of this License Agreement. XVI. %PDF-1.7 endstream endobj 1815 0 obj <>stream View Table of Contents for this Publication. II. THIS LIMITED WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS, AND YOU MAY ALSO HAVE OTHER RIGHTS THAT VARY FROM JURISDICTION TO JURISDICTION. Hard copies of 2020 Health Plan Accreditation Standards and Guidelines available for purchase. You will be prompted to log in to your NCQA account. 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. Eligibility requirements, application information and policies and procedures are also included. means youve safely connected to the .gov website. 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). Licensees employees who may access and use the Product is Licensed for the number of Licensed Users mean employees. Who may access and use the Product solely for a personal non-commercial purpose without NCQA. 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