Follow-up visits include: Medicare is a government national health insurance program in the United States, begun in 1965 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). Unless otherwise specified, administrative data sources are the states Medicaid Management Information System (MMIS) and/or data submitted by managed care plans; medical record data sources are paper and/or electronic health records. Utah Medicaid is in the process of replacing the Utah Medicaid Management Information System (MMIS) with a new system called Provider Reimbursement Information System for Medicaid (PRISM). In the future, the Scorecard will include a measure that reports on Emergency Departmentvisits among adult Medicaid beneficiaries. For more detailed information regarding payments or the MMIS implementation click on one of the links below: Provider FAQs - Posted 10/28/10; Member FAQs; General FAQs. If you disagree with a decision from the Department about the benefits you receive, you can appeal that decision. Poor control of diabetes is a risk factor for complications, including renal failure, blindness, and neurologic damage. For example, a state may include beneficiaries who are enrolled in managed care, but exclude beneficiaries who are covered on a fee-for-service (FFS) basis. Can the system handle international phone numbers? The primary contact should be the EUS Help Desk for users logging into I&A, NPPES, PECOS, and HITECH. The term states includes the 50 states, the District of Columbia, and Puerto Rico. States voluntarily report on Controlling High Blood Pressure (CBP-AD) as part of the Core Set ofAdult Health Care Quality Measures. Employer orientations scheduled through the end of January 2022 will be virtual or by telephone. From a surviving child who is under age 21 years or is blind or permanently disabled (based on Social Security criteria), regardless of where he or she lives. Pregnant women are at higher risk of a low birth weight baby if they have: Tooth decay, or dental caries, is one of the most common chronic diseases in children. CMS was not able to verify information for Hawaii, Illinois, Kentucky, Mississippi, Montana, Oklahoma, Virginia, or Washington D.C. Data on states NCI administration come from NCI administrative records and reflect administration during the 2019-2020 and 2020-2021 reporting cycles. AZ reported data for FFY 2019 and AL (CHIP), ND, and WY (CHIP) reported data for CY 2019. Unless otherwise specified: ACO = Accountable Care Organization; AHRQ = Agency for Healthcare Research and Quality; CCO = Coordinated Care Organization; CHIP = Childrens Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CMO = Care Management Organization; CY = Calendar Year; ED = Emergency Department; EHR = Electronic Health Record; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HCBS = Home- and Community-Based Services; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner. The measurement period for this measure was January 1, 2019 to December 31, 2019. It is a single source of truth that unifies Medicaid and CHIP data and provides a centralized system for performing analysis. The National Provider Identifier (NPI) Enumerator is responsible for processing new NPI applications and processing changes of information for previously enumerated providers. More information will be provided if there are changes. In addition, states may include beneficiaries in some delivery systems, but exclude other delivery systems. The included populations and calculation methods for Child Core Set measures can vary by state. The purpledashed line represents the median, or middle, of all values reported. For example, some states include populations in certain programs, such as beneficiaries covered by Medicaid, but exclude beneficiaries in other programs, such as those dually eligible for Medicare and Medicaid. Ideally, patients should see a mental health provider within 7 days after discharge. For information on how to drive improvement on this measure, visit: www.cdc.gov/sixeighteen. Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Adult Core Set FFY 2020reporting cycle as of June 18, 2021; see2020ChildandAdult Health Care Quality Measures. States calculate a rate for each vaccine as well as two combination rates for this measure. For more information, read the TMHP bulletin issued January 18, 2022. This variation in populations can affect measure performance and comparisons between states. On the Home Page of the NPPES website, enter your I&A User ID and password. States can check for and address T-MSIS data submission errors or data quality concerns through the Operations Dashboard available on the CMS Enterprise Portal. The following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for this measure: AK, AL, AR, AZ, CO, IL, KY, ME, MI, MN, MO, MT, NC, NE, NY, OK, PR, SC, SD, TX, and WY. You must either answer three of the challenge/security questions associated with the User ID, or enter the required User Information associated with your account (see an example screen shot below). The Division of Children and Family Services works to ensure children and youth have a safe and stable home every day. We help states connect key stakeholders to streamline processes and give people access to information they need through a dynamic, flexible, and service-oriented MES integration platform. States report data for this measure on Form CMS-416, which is used by CMS to collect information about the EPSDT benefit. This may be different in a prescribing or referring scenario for Medicare. CMS did not include the rates for these states. These files include data on Medicaid and Childrens Health Insurance Program The term states includes the 50 states, the District of Columbia, and Puerto Rico. The hybrid method uses a combination of administrative and medical records data to identify services included in the numerator or to determine exclusions from the denominator based on diagnoses or other criteria. Some states reported exclusions from the denominator, as noted in the state-specific comments. The following state used NCQA 2019specifications: OR. Much of the information provided also applies to other healthcare programs administered by MDCH (e.g., Adult Benefits Waiver, If you have access to a Provider, you will have access to all NPIs associated with the Provider. Users should have their personal information associated to their I&A account information and establish surrogacy or employer connections as needed to allow others to work on their behalf in other CMS applications (NPPES, PECOS, HITECH). In addition, states may include beneficiaries in some delivery systems, but exclude other delivery systems. The purple dashed line represents the median, or middle, of all values reported. These figures include only those individuals who are eligible for comprehensive benefits (for example, emergency Medicaid, family planning-only coverage and limited benefit dual eligible individuals are excluded). In addition, states may include beneficiaries in some delivery systems, but exclude other delivery systems. National Core Indicators (NCI) In-Person Survey Call the Marketplace Call Center at 1-800-318-2596 to get details about Marketplace coverage. For more information on the Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17 (FUH-CH) measure, visit Child Health Care Quality Measures. ) or https:// means youve safely connected to the .gov website. Diabetic ketoacidosis Some states reported exclusions from the denominator, as noted in the state-specific comments. Denominators are assumed to be the measure-eligible population for states using the administrative method; states using the hybrid method often reported the sample size for the medical chart review rather than the measure-eligible population. For more information, see the HHSC alert posted on April 28, 2022. ACO = Accountable Care Organization; ADHD = Attention-Deficit/Hyperactivity Disorder; CCO = Coordinated Care Organization; CHIP = Childrens Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CPT = Current Procedural Terminology; CY = Calendar Year; ED = Emergency Department; EPSDT = Early and Periodic Screening, Diagnostic, and Treatment; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HCBS = Home- and Community-Based Services; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner. It is a new system your caregiver or home health attendant may use to document the services you receive. Explore the percentage of adults who received prescriptions for opioids at high dosage over a period of 90 days or more in each state. The measurement period for this measure was January 2019 to December 2019. DOM main switchboard phone: 601-359-6050. An oral health assessment (at ages 3 and 6) This variation in populations can affect measure performance and comparisons between states. Lower rates are better on this measure. States used Adult Core Set specifications, based on AHRQ 2020 specifications. The main call center switchboard will then route your call to the appropriate area. The purple dashed line represents the median, or middle, of all values reported. If a nursing home sends many residents to the hospital, it may indicate that the nursing home is not properly assessing or taking care of its residents. For answers to common questions, read the Texas Health Steps Telemedicine Guidance for Providers (PDF), updated on June 16, 2020. Low weight gain during pregnancy These data show performance rates for states that voluntarily reported the measure using Adult Core Set measure specifications. Partial hospitalizationswith a mental health provider Notes: The purple dashed line represents the median, or middle, of all values reported. State and federal government websites often end in .gov. States voluntarily report on Live Births Weighing Less Than 2,500 Grams (LBW-CH) as part of theCore Set of Children's Health Care Quality Measures. Interested providers should visit the Provider Vaccine Information webpage on the DSHS website. Please contact your state for all state-related Medicaid questions As a reminder, the Provider web portal address remains the same as the ACS Web portal is now redirecting you to the HP Web portal. The State Health System Performance measures show how states serve Medicaid and Childrens Health Insurance Program (CHIP) beneficiaries in eightareas: In some cases, states are just beginning to report these voluntary measures. A lock ( You can add up to two authentication devices/methods, a primary authentication device/method and an alternative authentication device/method. If you are an approved Authorized Official or Access Manager for your organization you will automatically have access to all the NPIs associated with the Providers for which your organization has an approved surrogacy connection for the NPPES business function. You can use: Mobile Phone (SMS/Text or Voice), landline phone (Voice) and Email Address (Email). AZ and KY reported data for FFY 2019. Screening Effective February 1, 2022, FMSAs can permanently conduct new employer orientation virtually (i.e., audio-visual) in addition to allowing in-person orientations, based on member preference. Please refer to CAHPS Home and Community-Based Services Survey for more information. This measure reports state performance on the percentage of adults ages 18 to 75 with Type 1 or Type 2 diabetes who had HbA1c in poor control (>9.0%) during the measurement year. HHSC has directed MCOs and DMOs to ensure members who turn 21 on or after March 18, 2020, continue to have access to Early and Periodic Screening, Diagnosis, and Treatment (EPDST) services through the public health emergency. PRISM will be fully operational with all remaining components Chronic health conditions, such as diabetes and hypertension Effective December 21, 2022, for all CHIP members, copayments are waived for COVID-19 related vaccines (and the administration of such vaccine), testing, and treatment, including preventative therapies and treatment of post-COVID conditions (long-haul COVID-19), and treatment of health conditions that may seriously complicate the treatment of COVID-19 during the period when a beneficiary is diagnosed with or is presumed to have COVID-19. The measurement period for this measure was January 2019 to December 2019. Physical examination Selecting Taxonomy on the top progression bar. The purple dashed line represents the median, or middle, of all values reported. Read the TMHP bulletin issued on February 22, 2022. You may submit the request by mail, f ax, or e-mail to one of the following: MDHHS/Medicaid Program Policy Division PO Box 30479 Lansing, MI 48909 or E-mail: MSA-Forms@Michigan.gov Notes: Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the Child Core SetFFY2020reporting cycle as of June 18, 2021; see 2020Child and Adult Health Care Quality Measures. High blood pressure, or hypertension, increases the risk of heart disease and strokethe leading causes of death in the United States. You may call (202) 727-5355 to locate your nearest IMA Service Center. Care Management. Provided by MCNA Dental through the Idaho Smiles program. For example, some states report a single combined rate for both the Medicaid and CHIP populations, but other states report separate rates for these populations. ACO = Accountable Care Organization; ADHD = Attention-Deficit/Hyperactivity Disorder; CCO = Coordinated Care Organization; CHIP = Childrens Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CPT = Current Procedural Terminology; CY = Calendar Year; ED = Emergency Department; EPSDT = Early and Periodic Screening, Diagnostic, and Treatment; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HCBS = Home- and Community-Based Services; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner. As individual circumstances vary, and for more information, please call the Estate Recovery Office at 866-849-3843 or email FinancialRecovery@dhw.idaho.gov, United Behavioral Health dba OptumProgram: Idaho Behavioral Health PlanAccreditation Status: Accredited (10/15/2021-10/17/2023)Accrediting Entity: National Committee for Quality Assurance (NCQA) Starting with the Federal Fiscal Year (FFY) 2019 reporting year, states had the option to have CMS calculate this measure using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Database. Vision and hearing screening For more information on the Use of Opioids at High Dosage in Persons Without Cancer (OHD-AD) measure, visitAdult Health Care Quality Measures. If one factor is compromised or broken, the attacker still has at least one more barrier to breach before successfully breaking into the target. Contact Us. Unless otherwise specified: The Business Mailing Address can be the same as the Business Practice Location Address if the provider can receive mail at the same location where he/she practices. Hospitalizations 10:52B establish the New Jersey County Option Hospital Fee Pilot Program to support local hospitals and to ensure that they continue to 6201. For example, a state may include beneficiaries who are enrolled in managed care, but exclude beneficiaries who are covered on a fee-for-service (FFS) basis. For more information on the Initiation & Engagement of Alcohol & Other Drug Dependence Treatment (IET-AD) measure, visitAdult Health Care Quality Measures. Unless otherwise specified: Over time, more states may choose to report these measures and work to incorporate them into quality improvement programs. This includes services that have been made available through telemedicine, telehealth, and audio-only methods during the COVID-19 public health emergency (PHE) as well as other services. These data show performance rates for states that voluntarily reported the measure using Adult Core Set measure specifications. You can find links to state contacts below. The following states did not report data for either the HPV or Combination 1 rate: AZ, AR, KS, ME, MT, and NY. Good oral health habits at home The medications also have side effects. It also reduces the risk of developing other serious conditions. Lower rates are better on this measure. An official website of the United States government For information on the testing and treatment of the uninsured for COVID-19 see the resources section of this page. Among diabetic patients, a Hemoglobin A1c (HbA1c) level greater than 9.0% indicates poor control of diabetes. 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