HEDIS Clause Samples

HEDIS. The Healthcare Effectiveness Data and Information Set developed by the National Committee for Quality Assurance.

HEDIS. Healthcare Effectiveness Data and Information Set developed and published by the National Committee for Quality Assurance. HEDIS includes technical specifications for the calculation of the Performance Measures. -- The definition for Kick Payment is hereby amended to read as follows:

HEDIS. The contractor shall submit annually, on a date specified by the State, HEDIS 3.0 data or more updated version, stratified by eligibility group: 1) aged, blind, and disabled; 2) AFDC/TANF; and 3) NJ FamilyCare and aggregate population data as well as, if available, the contractor's commercial and Medicare enrollment HEDIS data for its aggregate, enrolled commercial and Medicare population in the State or region (if these data are collected and reported to DHSS, a copy of the report should be submitted also to DMAHS) the following clinical indicator measures: Report Period Reporting Set Measures by Contract Year ---------------------- ---------------- childhood immunization status annually adolescent immunization status annually well-child care annually prenatal care in the first trimester annually low birth weight babies annually check ups after delivery annually prenatal care utilization annually

HEDIS. The contractor shall submit annually, on a date specified by the State, HEDIS 3.0 data or more updated version, aggregate population data as well as, if available, the contractor’s commercial and Medicare enrollment HEDIS data for its aggregate, enrolled commercial and Medicare population in the State or region (if these data are collected and reported to DHSS, a copy of the report should be submitted also to DMAHS) the following clinical indicator measures: HEDIS Report Period Reporting Set Measures by Contract Year *Childhood Immunization Status Annually *Adolescent Immunization Status Annually *Well-Child visits in first 15 months of life Annually * Well-Child visits in the 3rd, 4th, 5th, and 6th year of life annually Adolescent Well-Care Visits annually *Prenatal and Postpartum care annually Breast Cancer Screening annually Cervical Cancer Screening annually *Use of Appropriate Medication for People with Asthma annually Comprehensive Diabetes Care annually Childhood & Adolescent Immunization *NOTE: HEDIS data for NJ FamilyCare enrollees up to the age of 19 years must be reported separately.

HEDIS. The contractor shall submit annually, on a date specified by the State, HEDIS 3.0 data or more updated version, stratified by eligibility group: 1) aged, blind, and disabled; 2) AFDC/TANF; and 3) NJ FamilyCare and aggregate population data as well as, if available, the contractor's commercial and Medicare enrollment HEDIS data for its aggregate, enrolled commercial and Medicare population in the State or region (if these data are collected and reported to DHSS, a copy of the report should be submitted also to DMAHS) the following clinical indicator measures:

HEDIS. The contractor shall submit annually, on a date specified by the State, HEDIS 3.0 data or more updated version, aggregate population data as well as, if available, the contractor's commercial and Medicare enrollment HEDIS data for its aggregate, enrolled commercial and Medicare population in the State or region (if these data are collected and reported to DHSS, a copy of the report should be submitted also to DMAHS) the following clinical indicator measures: HEDIS Report Period Reporting Set Measures by Contract Year ---------------------- ---------------- Childhood Immunization Status annually Adolescent Immunization Status annually Well-Child Visits in first 15 months of life annually Well-Child Visits in the 3rd, 4th, 5th and 6th year of life annually Adolescent Well-Care Visits annually Prenatal and Postpartum Care annually Frequency of Ongoing Prenatal Care annually Breast Cancer Screening annually Childhood & Adolescent Immunization HEDIS data for NJ FamilyCare enrollees up to the age of 19 years must be reported separately.

HEDIS. “HEDIS” means the Healthcare Effectiveness Data and Information Set developed and published by the National Committee for Quality Assurance. HEDIS includes technical specifications for the calculation of performance measures.

HEDIS. HealthCare Effectiveness Data and Information Set (HEDIS) – The most widely used set of performance measures used in the managed care industry, designed to allow reliable comparison of the performance of managed health care plans. HEDIS is developed and maintained by the National Committee for Quality Assurance.