Federal Requirements
Plans do not need to report quality measures for 2019 performance. Prior year data for HEDIS measures will be used in 2021 Star Ratings for Medicare Advantage plans.
Exchange (MNSure) Plans
No changes announced as of April 7, 2020.
State of Minnesota Requirements
Medicaid Plans
DHS and MDH will allow health plans to request a waiver to report prior year rates if unable to complete chart reviews for this year. (Source: March 28, 2020 memorandum to health plans from MDH and DHS)
Commercial Plans
MDH will allow health plans to request a waiver to report prior year rates if unable to complete chart reviews for this year. (Source: March 28, 2020 memorandum to health plans from MDH and DHS)
NCQA Requirements
Following CMS guidance, plans do not need to report quality measures for 2019 performance. NCQA will not publish Health Plan Ratings in 2020.
For HEDIS measures requiring chart audits ("hybrid" measures), plans may report prior year audited data for accreditation purposes if they have lower rates this year that are the result of barriers to obtaining chart data from providers. NCQA will not publish Health Plan Ratings in 2020.
For HEDIS measures requiring chart audits ("hybrid" measures), plans may report prior year audited data for accreditation purposes if they have lower rates this year that are the result of barriers to obtaining chart data from providers. NCQA will not publish Health Plan Ratings in 2020.