Texas Administrative Code
Title 25 - HEALTH SERVICES
Part 1 - DEPARTMENT OF STATE HEALTH SERVICES
Chapter 421 - HEALTH CARE INFORMATION
Subchapter B - COLLECTION AND REPORTING OF HEALTH PLAN EMPLOYER DATA AND INFORMATION SET (HEDIS) FROM HEALTH MAINTENANCE ORGANIZATIONS (HMOS)
Section 421.24 - Verification of Data
Current through Reg. 49, No. 38; September 20, 2024
(a) The entire subset of HEDIS data specified by the Council on November 15th of the year for which the data are collected, and reported by the HMO to the Council shall be verified.
(b) HEDIS data shall be verified by HMOs at their own expense.
(c) Verification of HEDIS data shall be by an independent auditor using guidelines as developed by the National Committee for Quality Assurance (NCQA) in effect on November 15th of the year for which the data are collected. If no guidelines have been released by NCQA, the data will be verified in accordance with auditing procedures as specified by the Council. These auditing procedures shall be specified by the Council by November 15th of the year for which the data are collected.
