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Mental Health Parity
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires that Mental Health and Substance Use Disorder (MH/SUD) treatments covered by managed care organizations (MCOs) have benefit limitations that are equivalent to those for medical/surgical (M/S) services and are not applied...
https://www.hsag.com/en/myoregoneqro/mental-health-parity/Encounter Data Validation
Pursuant to Title 42 of the Code of Federal Regulations (42 CFR) §438.242, Oregon Health Authority (OHA) must ensure that each of its coordinated care organizations (CCOs) maintain a health information system that collects, analyzes, integrates, and reports data on areas including, but not...
https://www.hsag.com/en/myoregoneqro/encounter-data-validation/Regulatory Resources
This page compiles essential federal and state regulatory resources to help nursing homes understand and navigate applicable requirements. HSAG is not a regulatory agency and does not issue or enforce regulations. Federal Resources Certification and Compliance (CMS) Quality, Safety, and Oversight...
https://www.hsag.com/en/medicare-providers/nursing-homes/regulatory-resources/Quarterly Meeting Materials
Meeting materials are linked below. April 2022 Quarterly Meeting Wednesday, April 13, 2022Quality Directors Meeting Spring 2022 Slide Deck November 2017 Quarterly Meeting Wednesday, November 8, 2017 Meeting Agenda Overview of the Comprehensive Addiction and Recovery Act (CARA) Social Determinants...
https://www.hsag.com/en/florida-eqro/quarterly-meeting-materials/HITRUST
Based upon representation from management as to the accuracy and completeness of information provided, the procedures performed by an Authorized External Assessor to validate such information, and HITRUST's independent confirmation that the work was performed in accordance with the HITRUST®...
https://www.hsag.com/en/hitrust/Model Software Download
To download the data dictionary and the SAS program codes, please complete the required fields in the following form. This information will help us gain a better understanding of potential users and interested stakeholders. If an email address is provided, users may be contacted and receive...
https://www.hsag.com/en/healthcare-policy-quality-measurement/anticoagulant-related-bleeding-prediction-model/model-software-download/QAPI
Quality Assurance and Performance Improvement (QAPI) is a CMS‑required, structured approach that helps nursing home staff work together to proactively identify issues, test changes, and learn what works to address quality concerns before they become larger problems. HSAG’s QAPI Performance...
https://www.hsag.com/en/medicare-providers/nursing-homes/qapi/FAQs
If your question is not answered in the below Frequently Asked Questions, please send your query to: KElliott@hsag.com
https://www.hsag.com/en/florida-eqro/faqs/Risk Variable Specifications
Claims data provide information on the patient’s medical history, including healthcare utilization, comorbidities, and prescription medication use. This project offered an opportunity to explore risk variables that might be difficult to ascertain in routine clinical settings. Fifty-eight risk...
https://www.hsag.com/en/healthcare-policy-quality-measurement/anticoagulant-related-bleeding-prediction-model/risk-variable-specifications/Network Access Evaluations
Federal and state regulations governing Medicaid services require that each Coordinated Care Organization (CCO) maintains a network of appropriate healthcare providers to ensure adequate access to all services covered under the Medicaid contract. Each CCO must submit documentation to the state...
https://www.hsag.com/en/myoregoneqro/network-access-evaluations/