HEDIS Deadlines Approaching

It’s HEDIS® time again! Health plans should have data collection and audit activities in full swing for Healthcare Effectiveness Data Information Set (HEDIS®) 2018. High-performing plans will have started the hybrid chart collection and medical record review.

January 31 is the National Committee for Quality Assurance (NCQA) deadline for the HEDIS® 2018 Roadmap. This document is used by HEDIS® auditors as the backbone for evaluating a plan’s systems and processes to ensure the plan’s HEDIS® results comply with NCQA standards for reporting.

February 16 is the due date for submitting the Healthcare Organization Questionnaire (HOQ) to NCQA. Populating the HOQ can be confusing for some plans, but it is important to get it right to prevent surprises when it is time to upload final data submissions in June.

HEDIS® results are a significant portion of CMS Star Ratings and NCQA accreditation scores, so it is critical for plans to understand all the moving parts and multiple deadlines of the HEDIS® process. Gorman Health Group has the expertise to help your plan implement a robust strategy and targeted actions for delivering measurable HEDIS® improvements.


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Registration is now open for the Gorman Health Group 2018 Forum, April 25-26, 2018, at the Red Rock Resort ideally located near the Red Rock Canyon in Las Vegas.

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Anita Green
Anita Green

Senior Director, Compliance Solutions

Anita Green is Senior Director of Compliance Solutions at Gorman Health Group (GHG). Anita is a Registered Nurse with more than 30 years of health care experience, beginning her healthcare career in the U.S. Air Force. Anita has functioned in the role of hospital administrator for a 200+ bed hospital, also serving as a member of the senior leadership team and director of risk management with oversight accountability of patient advocacy, hospital security, and provider credentialing. Her clinical experience includes (but is not limited to) critical care nursing in both military and civilian settings, case management, utilization review, discharge planning and diabetic nurse education. Anita is a former Compliance and Privacy Officer for a multi-state Medicare Advantage Prescription Drug health plan, and in that role she supported new Medicare Advantage applications, service area expansions, CMS and Department of Insurance audits, transitions to new pharmacy benefit managers, systems implementation, and sales and marketing oversight. In her consultant capacity Anita has stepped in as interim Compliance Officer for several organizations and is comfortable providing compliance support and leadership to all operational aspects of managed care. Anita holds a BSN from University of Texas Health Science Center in San Antonio, and a Juris Doctor from St. Mary’s University School of Law.

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