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Texas Administrative Code (Last Updated: March 27,2024) |
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TITLE 25. HEALTH SERVICES |
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PART 1. DEPARTMENT OF STATE HEALTH SERVICES |
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CHAPTER 421. HEALTH CARE INFORMATION |
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SUBCHAPTER B. COLLECTION AND REPORTING OF HEALTH PLAN EMPLOYER DATA AND INFORMATION SET (HEDIS) FROM HEALTH MAINTENANCE ORGANIZATIONS (HMOS) |
SECTION 421.24. Verification of Data
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(a) The entire subset of HEDIS data specified by the Council on November 15th of the year for which the data are collected, and reported by the HMO to the Council shall be verified. (b) HEDIS data shall be verified by HMOs at their own expense. (c) Verification of HEDIS data shall be by an independent auditor using guidelines as developed by the National Committee for Quality Assurance (NCQA) in effect on November 15th of the year for which the data are collected. If no guidelines have been released by NCQA, the data will be verified in accordance with auditing procedures as specified by the Council. These auditing procedures shall be specified by the Council by November 15th of the year for which the data are collected. Source Note: The provisions of this §421.24 adopted to be effective July 15, 1997, 22 TexReg 6442; amended to be effective April 21, 1999, 24 TexReg 3090; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8842