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. Should Licensee have any questions about this License Agreement or the Product, please call NCQA at (202) 955-3500. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. 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. For Value Set Directory (VSD) Downloads. However, the 2020 Health Plan Survey Tool was released on March 30, 2020. Data allow identification of performance gaps and establishment of realistic targets for improvement. 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). You will be prompted to log in to your NCQA account. ]'SEWf?7'yh]u&fmk9x2:-.SH,nE}u9Ecn+i+`e)+uL,x u]M37?0BgQ1GyF7px` 16!Xb.$74"C)i^Y. {`8:qqa2,} Official websites use .govA 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. 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. The License is not transferable from Licensee to any other person, entity, organization or association. The evaluator will assess the practice's progress towards recognition and provide immediate personalized feedback. NCQA holds a copyright in the measures and specifications and may rescind or alter these measures and specifications at any time. delivery, on behalf of the physician and patient community, we urge adoption of NCQA standards in this area. 0 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. THIS LIMITED WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS, AND YOU MAY ALSO HAVE OTHER RIGHTS THAT VARY FROM JURISDICTION TO JURISDICTION. %PDF-1.7 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). 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. Save your favorite pages and receive notifications whenever theyre updated. A Licensed User must be using the Product under the License and solely on behalf of the Licensee. 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. AssignmentLicensee shall not assign this License Agreement without the written consent of NCQA. Upon accessing the Product, the Licensee is deemed to have accepted the license subject to the terms and conditions of this License Agreement. 3 0 obj lock Copyright 2023 National Committee for Quality Assurance. ("NCQA"). You will be prompted to log in to your NCQA account. The 2020 Health Plan Accreditation Standards and Guidelines were released on July 29, 2019. Copyright 2023 National Committee for Quality Assurance. 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. endobj 11/25/2019 3:59:12 PM . 0 (PDF). . 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. h\AN@E27dRTQbQB*=vX{r$e K8Z+*;e_?St*[|e[o-;/6MpnC\Hdy rL|LIr2e_D,F1+^1W+s N$oK)R493{py #xtV>zxk13No9:C_ eH__C/WpGOav4 endstream endobj 289 0 obj <> endobj 290 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Type/Page>> endobj 291 0 obj <>stream ) TerminationNCQA may terminate this License Agreement at any time and without notice if Licensee violates any of the terms and conditions hereof. This License Agreement will not be governed by the United Nations Convention on Contracts for the International Sale of Goods, the application of which is expressly excluded. y+,^ y{Ay|kd Y|E1/!s|_+Le{l|1gc0Ow. &eNA!$}(5I6KA"+D}Qt\V+Zs1eM6fz:srrhdkqJ)> *>ogVwIHL)xL\0BZb)Ct>#5L9VQSUHU?8.ttE3zVu8bq-&. 9.v h)f -2OJ v)TXS=p 8U&s$\m 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. RnI0O [.A 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. 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. Health Insurance Plan Network Narrowing . 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. %%EOF Terms of Use, 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. Review the corrections, clarifications and policy changes to the most recent Standards and Guidelines forNCQA programsand incorporate them intoyourimplementation processes. 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. 0 ePub: A downloadable PDF version of the standards, Web-based: A license to access a web-based version of the standards through IRT. This License Agreement will not be governed by the United Nations Convention on Contracts for the International Sale of Goods, the application of which is expressly excluded. Share sensitive information only on official, secure websites. JavaScript seems to be disabled in your browser. May 2019 : Added clarifying language to content in each section . Sign up to get the latest information about your choice of CMS topics. CMS contracted with NCQA to develop a strategy to evaluate the quality of care provided by SNPs. 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's Patient-Centered Medical Home Recognition Program is the most widely adopted Patient-Centered Medical Home evaluation program in the country. 57awmjUkP%N^H/I[d 8h,jsqQ'PFp&gjFo 0oN/wOptE"oKx Uawh/.S >t <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The Product is protected by applicable United States and foreign laws and treaties, including copyright laws and treaty provisions. XII. 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. Copyright 2023 National Committee for Quality Assurance. We look forward to further dialogue . G'a8 z ,hI:0` Mdm9V@ 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 hb```f``*e`e` ",l@qA $2>Qs*C>2bf.6AB^;x1K_YlQlqc]>'@2'oSQ"|*x TdB^9WACh0F This page contains the latest updates to interpretations of NCQA standards and measures, as well as resources that can help you interpret and implement NCQA standards. JavaScript seems to be disabled in your browser. Requirements cover these key areas: To see all program requirements, get the Standards and Guidelines document. A Licensed User may not be an agent or consultant of a Licensee. NCQA's PCMH program is the largest, with more than 65,000 cliniciansabout 18 percent of all primary care cliniciansat 14,000 sites as of June 2018. THE USE OF THE DATA WITHIN ANY PRODUCT IS ENTIRELY AT LICENSEES OWN RISK AND NCQA SHALL HAVE NO LIABILITY OR RESPONSIBILITY THEREFOR. Except for authorized Licensed Users, each person, entity, organization or association, including agents and consultants of the Licensee, is required to separately purchase a license to obtain and access the Product. 4O?g{d~F&[EecTvH3=xbfU21vQ 8 hV[o;+~l^[CE"6*`o]B&VfyT &b:@5fQ%D3f Q2A5&1?Z2LZ1%j[X$c|5h(C.c92 5Qlfb9w|UWl1w U9Ldd|V.hsGBt,Bu T#l+ Dv.E Zv?bkvir{~Y&m:S 59CNByOzdm tG+~zM~8j 0 ( Using appropriate professionals. Share this page with a friend or colleague by Email. National Committee for Quality Assurance (NCQA)* Medicaid Healthcare Maintenance Organization Accreditation** Version Date: July 1, 2019 Accreditation Level Description of Accreditation Level Denied NCQA awards a status of Denied Accreditation to organizations whose programs for service and clinical quality do not meet NCQA requirements. . 2'sYP'IeIFH5-st#,Z5v&*}"xC0!"#:#}?rjJS',#l2u)h3p+a:fRlA8E@9~fBa"=KQY(?\mq1)gg$\y#cvnG54h0'[#0YNdR8}2e. <> Cant find the answer to your question in the FAQs? These third party medical and billing codes are protected under federal copyright laws. Relevant records as used in this paragraph shall include all computer systems; software products; and print and electronic books and records. Requiring all Covered California QHPs achieve NCQA accreditation will be minimally disruptive as NCQA Unauthorized internal distribution of the Product and materials therein - beyond the number of Licensed Users by your organization - is prohibited. endstream endobj startxref Licensed Users mean Licensees employees who may access and use the Product on behalf of the Licensee. NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. endobj 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. 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. 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. 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 established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. 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. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Contact and Notices. EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2020 ONWARD. 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. IX. <> endstream endobj startxref VIII. A$"0< -@ cfa+`}0@9w.IGX'b;|OI Copyright 2023 National Committee for Quality Assurance. endstream endobj 1815 0 obj <>stream .gov 89 0 obj <> endobj XV. Heres how you know. 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. We do not share your information with third parties. Start with . A Licensed User may not be an agent or consultant of a Licensee. NCQA DISCLAIMS WARRANTIES OF SEQUENCE, ACCURACY AND COMPLETENESS OF DATA. You will be prompted to log in to your NCQA account. NCQA PCMH 2017 Standards Intro 3/29/18 4 A check-in will be conducted virtually online with an NCQA evaluator. 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. 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. Prohibited Use AcknowledgmentAn organizations Licensed Users may use the Product solely for a personal non-commercial purpose without obtaining NCQA approval. and Scoring NCQA Requirements Additional NCQA Guidance ; PHM 2 Element A; To fully meet the criteria the organization must meet 3-7 factors. means youve safely connected to the .gov website. IF APPLICABLE, LICENSEE IS RESPONSIBLE FOR PROCURING ALL EQUIPMENT AND SOFTWARE REQUIRED IN CONNECTION WITH THE USE OF THE PRODUCT. endobj Share this page with a friend or colleague by Email. A PDF reader is . 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. h[k1B{%~3:sF4&%=! 19\-% Appropriate client agreements and collaboration. XV. 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. endstream endobj 90 0 obj <> endobj 91 0 obj <> endobj 92 0 obj <>stream 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. 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. 4 0 obj Users of these Products will be required to accept a separate Usage Agreement in NCQAs Download Center before accessing the Products. 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. For the best experience on our site, be sure to turn on Javascript in your browser. The Product is being licensed (not sold) to you, the Licensee (the License). 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. 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. 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Licensee is RESPONSIBLE for PROCURING all EQUIPMENT and software REQUIRED in CONNECTION with the Licensee records as used in paragraph... Of SEQUENCE, ACCURACY and COMPLETENESS of DATA in NCQAs Download Center before accessing the Product, call... Be an agent or consultant of a Licensee the country & %!. Share this page with a friend or colleague by Email Agreement without the written consent NCQA... Standards Intro 3/29/18 4 a check-in will be prompted to log in to question! Prompted to log in to your NCQA account by SNPs NCQA established Healthcare Effectiveness DATA and information Set HEDIS... Without obtaining NCQA approval may access and USE the Product is Licensed for best... A friend or colleague by Email requirements, get the Standards and Guidelines were released on July,.