Diabetes Care for People with Serious Mental Illness - HA1c Testing Poor Control (>9%) (HPCMI, CMS Adult Core Set)

LICENSE AGREEMENTS AND ACKNOWLEDGMENTS

Utilizing the Technical Specifications and Resource Manual and the Value Sets for the Adult and Child Core Set and data from this report indicates your agreement and acceptance of the following license agreements and acknowledgements.

The American Medical Association (AMA) and the American Hospital Association (AHA) permit the use of Current Procedural Terminology (CPT) and National Uniform Billing Committee (NUBC) UB-04 codes solely for the purpose of reporting state data on Medicaid and CHIP Core Set measures to the Centers for Medicare & Medicaid Services (CMS).

The National Committee for Quality Assurance (NCQA), the Pharmacy Quality Alliance (PQA), and the National Association of State Directors of Developmental Disabilities Services (NASDDDS)/Human Services Research Institute (HSRI) permit the use of their technical specifications solely for the purpose of reporting state data on Medicaid and CHIP Core Set measures to the Centers for Medicare & Medicaid Services (CMS).

This HEDIS® Value Set Directory (HEDIS VSD) was developed by and is owned by the National Committee for Quality Assurance (NCQA). NCQA holds a copyright in the HEDIS VSD and may rescind or alter the HEDIS VSD at any time. Users shall not have the right to alter, enhance or otherwise modify the HEDIS VSD, and shall not disassemble, recompile or reverse engineer the HEDIS VSD. Anyone desiring to use or reproduce the HEDIS VSD without modification for an internal non-commercial purpose may do so without obtaining approval from NCQA. All other uses, including a commercial use and/or external reproduction, distribution or publication must be approved by NCQA and are subject to a license at the discretion of NCQA. The HEDIS VSD is provided “as is” without warranty of any kind.

The HEDIS VSD contains proprietary code values owned by third parties that are protected under federal copyright laws. All uses of the third-party codes may require a license from the copyright owner. NCQA disclaims all liability for use of the third-party codes.

CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

For Proprietary Codes in the Adult Core Set:

CPT ® codes, descriptions and other data only are copyright 2023 American Medical Association (AMA). All rights reserved. CPT is a trademark of the American Medical Association. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained or not contained herein. Applicable FARS/HHSARS restrictions apply to government use.

The Uniform Billing Codes (UB) are Copyright © 2023, the American Hospital Association (AHA), Chicago, Illinois. The UB Codes are included with the permission of the AHA. All uses of the UB Codes may require a license from the AHA. Specifically, anyone desiring to use the UB Codes in a commercial manner must obtain a commercial use license directly from the AHA. To inquire about licensing, contact ub04@aha.org.

Some measure specifications contain coding from LOINC ® (https://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright © 1995–2023, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at https://loinc.org/terms-of-use.

“SNOMED” and “SNOMED CT” are registered trademarks of the International Health Terminology Standards Development Organisation (IHTSDO).

“HL7” is the registered trademark of Health Level Seven International.

For NCQA measures in the Adult Core Set:

HEDIS® is a registered trademark of the National Committee for Quality Assurance (“NCQA”). The HEDIS measures and specifications are owned by NCQA. NCQA holds a copyright in these materials and may rescind or alter these materials at any time. Users of the HEDIS measures and specifications shall not have the right to alter, enhance or otherwise modify the HEDIS measures and specifications, and shall not disassemble, recompile, or reverse engineer the HEDIS measures and specifications. Anyone desiring to use or reproduce the materials without modification for the sole purpose of Core Set reporting may do so without obtaining any approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using the measures and specifications with a product or service to calculate measure results), must be approved by NCQA and are subject to a license at the discretion of NCQA.

HEDIS measures and specifications are not clinical guidelines, do not establish a standard of medical care and have not been tested for all potential applications. The measures and specifications are provided “as is” without warranty of any kind. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of a HEDIS measure or specification. NCQA also makes no representations, warranties or endorsements about the quality of any organization or clinician who uses or reports performance measures. NCQA has no liability to anyone who relies on HEDIS measures and specifications or data reflective of performance under such measures and specifications.

Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. NCQA disclaims all liability for use or accuracy of any coding contained in the specifications.

CPT® codes copyright 2023 American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/HHSARS restrictions apply to government use.

The American Hospital Association holds a copyright to the Uniform Billing Codes (UB) contained in the HEDIS Value Set Directory (VSD). The UB Codes are included with the permission of the AHA. All uses of the UB Codes may require a license from the AHA. Specifically, anyone desiring to use the UB Codes in a commercial manner to generate measure results or for any other commercial use, must obtain a commercial use license directly from the AHA. To inquire about licensing, contact ub04@aha.org.

NCQA Measure Certification Notice:

A calculated measure result (a “rate”) from a HEDIS measure that has not been certified via NCQA’s Measure Certification Program, and is based on unadjusted HEDIS specifications, may not be called a “Health Plan HEDIS rate” until it is audited and designated reportable by an NCQA-Certified HEDIS Compliance Auditor. Until such time, such measure rates shall be designated or referred to as “Uncertified, Unaudited Health Plan HEDIS Rates.”

© 2023 by the National Committee for Quality Assurance, all rights reserved.

For Codes in the Public Domain used in the Adult Core Set measures:

The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is published by the World Health Organization (WHO). ICD-10-CM is an official Health Insurance Portability and Accountability Act standard.

The International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) is published by the World Health Organization (WHO). ICD-10-PCS is an official Health Insurance Portability and Accountability Act standard.

The National Drug Code (NDC) Directory is published by the U.S. Food and Drug Administration and is made available under the Open Database License at https://opendatacommons.org/licenses/odbl/1-0/.

Any rights on individual contents of the database are licensed under the Database Contents License at https://opendatacommons.org/licenses/dbcl/1-0/.