FEHB Plans must begin to report on HEDIS standards in 2007

OPM issued a carrier letter today on its new 2007 requirement (described in the call letter) that fee-for-service plans report on certain HEDIS measures. The HEDIS measures concern the extent to which network health providers follow certain procedures. OPM will require the plans to collect data on breast cancer screening, cholesterol management for patients with cardiovascular conditions, and comprehensive diabetes care.

The OPM letter advises that “FEHB carriers will need to follow NCQA’s procedures for HEDIS reporting,including the HEDIS Compliance Audit which can be found on their website. The precise ncqa.com link for the HEDIS program is here and the link for the audit program is here .

In its April 7 press release, NCQA touts this development:“As the nation’s largest employer, the federal government has made a very powerful statement that every American needs good, comparable information about health care quality, regardless of the type of health plan they choose,” said NCQA President Margaret E. O’Kane. “When fee-for-service plans start reporting HEDIS data, for the first time federal workers will be able to determine which plans offer them the greatest value, and help keep their families the healthiest.”