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NCQA announces new HEDIS and CAHPS reporting policies

NCQA said that it will not require MA health plans to submit their data for accreditation purposes now that the Centers for Medicare & Medicaid Services (CMS) has removed its requirement that MA plans submit 2020 HEDIS and CAHPS data for MY 2019.


Policy update for Commercial and Medicaid Accreditation and Reporting


NCQA is moving ahead with its annual requirements for the collection of HEDIS and CAHPS data through the IDSS tool for accredited commercial and Medicaid plans. Non-accredited plans may also submit information.


However, the organization said it expects that the data it receives will likely not be conducive to the calculation of overall plan ratings.


“Therefore, NCQA will not use Health Plan Ratings for Accreditation scoring in 2020. We will continually assess the feasibility of using the data reported to us for other purposes, provided they meet our usual standards for validity, accuracy and completeness,” it said in the policy update.


Policy exceptions


The organization said it recognizes the need for health plans to focus on COVID-19, so it has implemented disaster protocols that allow for exceptions to the reporting requirements. Therefore, it will try to work with commercial and Medicaid plans that have difficulty submitting data. Furthermore, if states make different decisions about HEDIS and CAHPS reporting, the organization will abide by those decisions.


In all cases, the IDSS tool will be available for internal quality improvement purposes.


NCQA said it will continue to follow the COVID-19 developments and will update policies as necessary.