Quality Programs: HEDIS & PQA
Provider Forms
File Name | Format | Updated |
---|---|---|
HEDIS Best Practices Guide for Providers (Measurement Year 2023) | Apr 2023 |
HEDIS Measures Tip Sheet
Healthcare Effectiveness Data and Information Set (HEDIS)
PQA Measures Tip Sheet
Pharmacy Quality Alliance (PQA)
Pharmacy Quality Alliance (PQA) Quality Measures Tip Sheets |
Date Published |
Applies to: |
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---|---|---|---|---|---|
Florida Blue |
FEP |
Florida Blue |
Florida Blue |
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Adherence to Antipsychotic Medications for Schizophrenia (SAA) | Feb 2024 | ✓ |
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Concurrent Use of Opioids and Benzodiazepines (COB) | Mar 2025 | ✓ | ✓ | ||
International Normalized Ratio Monitoring of Those on Warfarin (INR) | Feb 2024 | ✓ |
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Mar 2024 |
✓ |
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✓ |
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Mar 2024 |
✓ |
|
✓ |
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Mar 2024 |
✓ |
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✓ |
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Monitoring of Individuals on Long-Term Opioid Therapy (AMO) | Feb 2024 | ✓ |
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Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (POLY-ACH) | Mar 2025 | ✓ | |||
Mar 2024 |
✓ |
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✓ |
|
1 HEDIS Measure Specifications
Copyright Notice and Disclaimer for Licensees
The Healthcare Effectiveness Data and Information Set (HEDIS®) measures and specifications were developed by and are owned by the National Committee for Quality Assurance (NCQA). The HEDIS measures and specifications are not clinical guidelines and do not establish a standard of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures and specifications. NCQA holds a copyright in these materials and can rescind or alter these materials at any time. These materials may not be modified by anyone other than NCQA. Use of the Rules for Allowable Adjustments of HEDIS to make permitted adjustments of the materials does not constitute a modification. Any commercial use and/or internal or external reproduction, distribution and publication must be approved by NCQA and are subject to a license at the discretion of NCQA. Any use of the materials to identify records or calculate measure results, for example, requires a custom license and may necessitate certification pursuant to NCQA’s Measure Certification Program. Reprinted with permission by NCQA. © 2025 NCQA, all rights reserved. Limited proprietary coding is contained in the measure specifications for convenience. NCQA disclaims all liability for use or accuracy of any third-party code values contained in the specifications. Current Procedural Technology (CPT) Copyright 2025 American Medical Association (AMA). All rights reserved. CPT® is a registered trademark of the American Medical Association. Applicable Federal Acquisition Regulation Supplement (FARS) and Defense Federal Acquisition Regulation Supplement (DFARS) restrictions apply to government use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
2 Federal Employee Program®
3 Health coverage is offered by Truli for Health, an affiliate of Florida Blue. These companies are Independent Licensees of the Blue Cross and Blue Shield Association.
* Truli for Health will not include influenza in CIS measurement.