Required Program Reports Sample Clauses
Required Program Reports. (a) Clinical Data
i. The MA Health Plan must report clinical indicator data to EOHHS for all Dual Eligible Members in accordance with the specific HEDIS measures developed for Medicare Advantage Special Needs Plans (SNPs) by the National Commission on Quality Assurance (“NCQA”). The MA Health Plan must comply with, and report to EOHHS, the HEDIS SNP Measures as required and approved by NCQA and CMS and report to EOHHS on the same time schedule required by CMS.
ii. The HEDIS measures must be collected according to HEDIS specifications or other specifications as specified by EOHHS, and reported to EOHHS with the annual reports, unless CMS requires submission of those materials on a different time schedule.
(b) Consumer Assessment of Healthcare Providers and Services (“CAHPS”) Data
i. The MA Health Plan must submit CAHPS data for its Dual Eligible members described in Appendix A to EOHHS annually, on the anniversary of the start date of the Agreement.
Required Program Reports. (a) Clinical Data
i. The MA Health Plan must report clinical indicator data for all Enrollees in accordance with the specific HEDIS measures developed for Medicare Advantage Special Needs Plans (SNPs) by the National Commission on Quality Assurance (NCQA). The MA Health Plan must comply with, and report to EOHHS, the HEDIS SNP Measures as required and approved by NCQA and CMS and report to EOHHS on the same time schedule required by CMS.
ii. The HEDIS measures must be collected according to HEDIS specifications or other specifications as specified by EOHHS, and reported to EOHHS with the annual reports, unless CMS requires submission of those materials on a different time schedule.
(b) Consumer Assessment of Healthcare Providers and Services (CAHPS) Data
i. The MA Health Plan must submit the Consumer Assessment of Healthcare Providers and Services (CAHPS) data to EOHHS annually, on the anniversary of the start date of the Contract.
Required Program Reports. A. Clinical Indicator Data
1. The Contractor must report clinical indicator data in accordance with the specific HEDIS measures developed for Medicare Advantage Special Needs Plans (SNPs) by the National Commission on Quality Assurance (NCQA), to the extent they are relevant to the SCO population.
2. For calendar year 2009, the following HEDIS measures must be collected according to HEDIS specifications, and reported to EOHHS on the same time schedule required by CMS.
a. Glaucoma Screening for Older Adults;
b. Use of Spirometry Testing in the Assessment and Diagnosis of COPD;
c. Persistence of Beta Blocker Treatment after a Heart Attack;
d. Osteoporosis Management in Older Women;
e. Antidepressant Medication Management;
f. Follow-up After Hospitalization for Mental Illness;
g. Annual Monitoring for Patients on Persistent Medication;
h. Potentially Harmful Drug-Disease Interactions;
i. Use of High-Risk Medication in the Elderly; and
j. Board Certification.
Required Program Reports. 7.3.1 Performance Measures using Healthcare Effectiveness Data & Information Set (HEDISâ) and Non-HEDIS Measuresâ)
7.3.2 In accord with the Notices provisions of the General Terms and Conditions Section of this Contract, the Contractor shall report to HCA HEDISâ measures using the current HEDISâ Technical Specifications and official corrections published by NCQA, unless directed otherwise in writing by HCA. For the HEDIS® measures listed below, the Contractor shall use the administrative or hybrid data collection methods, specified in the current HEDISâ Technical Specifications, unless directed
7.3.3 In addition, the Contractor shall collect and report the non-HEDISâ measures, identified as such, following specifications provided by HCA.
7.3.4 No later than June 15 of each year, HEDISâ and non- HEDISâ measures shall be submitted electronically to HCA using the NCQA Interactive Data Submission System (IDSS) or other NCQA-approved method and methods provided by HCA to the Contractor for non- HEDISâ measures.
7.3.4.1 The following HEDIS® and non-HEDISâ measures shall be submitted to HCA in reporting year 2015; for the data collection period January 1, 2014 through December 31, 2014.
7.3.4.2 Use of Appropriate Medications for People with Asthma
7.3.4.3 Plan All Cause Readmission
7.3.4.4 Inpatient Utilization – General Hospital/Acute Care
7.3.4.5 Ambulatory Care (Outpatient and Emergency Department visits)
7.3.4.6 Preventable Non-Emergent Emergency Room Rates – non-HEDIS®
7.3.4.7 Initiation and engagement of alcohol and substance use treatment for program enrollees.
7.3.4.8 Comprehensive Diabetes Care (Hemoglobin A1c Testing and LDL-C Screening)
7.3.4.9 Antidepressant Medication Management (Acute Phase and Continuation Phase) 7.3.4.10 Controlling High Blood Pressure