{"id":15345,"date":"2020-03-13T12:18:10","date_gmt":"2020-03-13T16:18:10","guid":{"rendered":"https:\/\/www.ncqa.org\/?page_id=15345"},"modified":"2025-12-02T16:31:01","modified_gmt":"2025-12-02T21:31:01","slug":"hedis-and-covid-19","status":"publish","type":"page","link":"https:\/\/www.ncqa.org\/hedis\/measures\/hedis-and-covid-19\/","title":{"rendered":"HEDIS and COVID-19"},"content":{"rendered":"<p><strong>Updated: April 6, 2020<\/strong><br \/>\n<strong>Posted: March 13, 2020<br \/>\n<\/strong><strong>See also:\u00a0<a href=\"https:\/\/www.ncqa.org\/covid\/\">Main NCQA COVID updates<\/a>.<\/strong><\/p>\n<p>We realize\u00a0that\u00a0the virus may\u00a0affect\u00a0your\u00a0operations, audits\u00a0and the availability of documentation needed to meet HEDIS<sup>\u00ae<\/sup>\u00a0program requirements.<\/p>\n<p>NCQA realizes also that COVID-19 might have an effect on the HEDIS hybrid measures and the ability to collect medical record data because of imposed travel bans, quarantines and risk to staff. NCQA recommends using caution and limiting travel to ensure the safety of your employees and business partners. When possible, organizations should continue to use medical record procurement processes that do not require travel, including virtual\/online reviews and fax\/mail. We informed HEDIS auditors that they may conduct site visits remotely, and we recommend that auditors work with their clients to determine how best to conduct upcoming audits.<\/p>\n<p><strong>For commercial and Medicaid plans reporting to NCQA, for measures reported using the hybrid methodology only, we will allow plans to report their audited HEDIS 2019 hybrid rate if it is better than their HEDIS 2020 hybrid rate as a result of low chart retrieval.\u00a0<\/strong><em>[Updated April 6: See\u00a0<a href=\"https:\/\/www.ncqa.org\/hedis\/faq\/?faq-kw=covid&amp;faq-year=&amp;faq-sort=desc&amp;faq-program=\">COVID FAQs<\/a>\u00a0for clarification about low chart retrieval.]<\/em>\u00a0 If you choose to submit your HEDIS 2019 hybrid\u00a0rate for a hybrid measure, work with your auditor to ensure that the rate is accurately reported in IDSS. No exceptions are being made for administrative rates\u00a0which\u00a0should be reported following HEDIS 2020 reporting requirements.<\/p>\n<p>For plans in states with mandatory HEDIS reporting requirements, we recommend states allow the use of HEDIS 2019 rates if the plan has a low chart retrieval rate.\u00a0<em>[Updated April 6: See\u00a0<a href=\"https:\/\/www.ncqa.org\/hedis\/faq\/?faq-kw=covid&amp;faq-year=&amp;faq-sort=desc&amp;faq-program=\">COVID FAQs<\/a>\u00a0for clarification about low chart retrieval.]\u00a0<\/em>We are communicating this recommendation directly to state Medicaid leadership as well. Additional guidance is forthcoming regarding Medicare health plans and commercial plans reporting for the Health Insurance Exchange Quality Ratings System<em>. [Update: CMS\u2019 Medicare guidance was received and incorporated into NCQA policy changes Friday, April 3.]\u00a0<\/em>We will keep you\u00a0informed as we learn more.<\/p>\n<p>If you have any questions, please contact us through\u00a0<strong><a href=\"https:\/\/my.ncqa.org\/\">My NCQA.<\/a><\/strong>\u00a0Log in and select\u00a0<strong>My Questions &gt; Ask A Question &gt; PCS &gt; Product\/Program Type: HEDIS\u00a0<\/strong>\u00a0<strong>&gt;\u00a0General Content Area:\u00a0COVID-19.\u00a0<\/strong><\/p>\n<p>Thank you,<br \/>\nNCQA<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Updated: April 6, 2020 Posted: March 13, 2020 See also:\u00a0Main NCQA COVID updates. We realize\u00a0that\u00a0the virus may\u00a0affect\u00a0your\u00a0operations, audits\u00a0and the availability of documentation needed to meet HEDIS\u00ae\u00a0program requirements. NCQA realizes also that COVID-19 might have an effect on the HEDIS hybrid measures and the ability to collect medical record data because of imposed travel bans, quarantines [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":2634,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page.php","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-15345","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>HEDIS and COVID-19 - NCQA<\/title>\n<meta name=\"description\" content=\"NCQA is aware of the impact COVID-19 is having across the country.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ncqa.org\/hedis\/measures\/hedis-and-covid-19\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HEDIS and COVID-19 - NCQA\" \/>\n<meta property=\"og:description\" content=\"NCQA is aware of the impact COVID-19 is having across the country.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ncqa.org\/hedis\/measures\/hedis-and-covid-19\/\" \/>\n<meta property=\"og:site_name\" content=\"NCQA\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/NCQA.org\" \/>\n<meta property=\"article:modified_time\" content=\"2025-12-02T21:31:01+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ncqa.org\/wp-content\/uploads\/2021\/04\/NCQA_cmyk_tag.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"627\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@NCQA\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.ncqa.org\/hedis\/measures\/hedis-and-covid-19\/\",\"url\":\"https:\/\/www.ncqa.org\/hedis\/measures\/hedis-and-covid-19\/\",\"name\":\"HEDIS and COVID-19 - NCQA\",\"isPartOf\":{\"@id\":\"https:\/\/www.ncqa.org\/#website\"},\"datePublished\":\"2020-03-13T16:18:10+00:00\",\"dateModified\":\"2025-12-02T21:31:01+00:00\",\"description\":\"NCQA is aware of the impact COVID-19 is having across the country.\",\"breadcrumb\":{\"@id\":\"https:\/\/www.ncqa.org\/hedis\/measures\/hedis-and-covid-19\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.ncqa.org\/hedis\/measures\/hedis-and-covid-19\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.ncqa.org\/hedis\/measures\/hedis-and-covid-19\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.ncqa.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"HEDIS\",\"item\":\"https:\/\/www.ncqa.org\/hedis\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"HEDIS Measures and Technical Resources\",\"item\":\"https:\/\/www.ncqa.org\/hedis\/measures\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"HEDIS and COVID-19\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.ncqa.org\/#website\",\"url\":\"https:\/\/www.ncqa.org\/\",\"name\":\"NCQA\",\"description\":\"Measuring quality. 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