Utah Administrative Code
Topic - Health
Title R428 - Center for Health Data, Health Care Statistics
Rule R428-13 - Health Data Authority. Audit and Reporting of Health Plan Performance Measures
Section R428-13-3 - Submission of Performance Measures

Universal Citation: UT Admin Code R 428-13-3

Current through Bulletin 2024-06, March 15, 2024

(1) Each carrier shall compile and submit HEDIS data for the preceding calendar year to the Office by July 1 of each year.

(2) By January 1 of each year, each carrier shall submit to the Office a plan for creating and providing HEDIS data for the preceding calendar year.

(3) Each carrier shall contract with an independent audit agency certified by the NCQA to verify the HEDIS data using NCQA HEDIS specifications prior to submitting data to the Office.

(4) Each carrier may employ the rotation strategy for HEDIS measures developed and updated by NCQA.

(5) If a carrier presents "Not Reported (NR)" for required measures, it must document why it did not report the required measure.

(6) Each carrier shall cause its contracted audit agency to submit a copy of the audit agency's final report by August 15 of the submission year to the Office. The final report shall incorporate the carrier's comments.

Disclaimer: These regulations may not be the most recent version. Utah may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.