Health Insurance Marketplace Quality Initiatives
- CMS has posted the 2022 Quality Rating System Measure Technical Specifications (PDF), which includes the measure specifications and guidelines for data collection for the 2022 QRS measure set. QHP issuers will need to reference this document in order to collect and submit QRS measure data to CMS in accordance with the QRS2022 requirements. QHP issuers with questions regarding the QRS or the QHP Enrollee Survey should contact the Marketplace Service Desk (CMS_FEPS@cms.hhs.gov) and reference the Marketplace Quality Initiatives or "MQI-QRS."
- The Quality Improvement Strategy (QIS) materials for the 2022 Plan Year are now available for issuers to download on the Downloads page.
o The QIS Issuer List for the 2022 Plan Year (XLSX) includes issuers operating in Federally-facilitated Exchanges (FFEs) and FFEs where States perform plan management that meet the QIS participation criteria and are required to implement and report on at least one QIS as a condition of Qualified Health Plan (QHP) certification for the 2022 Plan Year. The QIS Implementation Plan form (PDF) and Progress Report form (PDF) for the 2022 Plan Year (QIS forms) collect QIS information from issuers in order to demonstrate compliance with section 1311(c)(1)(E) of the Patient Protection and Affordable Care Act.
o The QIS Technical Guidance and User Guide for the 2022 Plan Year (PDF) communicates finalized QIS requirements and instructions for how to complete the QIS form.
o Issuers should submit questions about QIS to CMS' Marketplace Service Desk (MSD) by phone at 1-855-CMS-1515 (1-855-267-1515) or by email at CMS_FEPS@cms.hhs.gov. When submitting inquiries via email, please include "MQI-QIS" and your HIOS Issuer ID in the subject line or body of the email.
- CMS released the Plan Year 2021 Nationwide Quality Rating System Public Use File (PUF) to outline underlying measure data (i.e., measure rates and denominators) as well as star ratings for all eligible Qualified Health Plan (QHP) issuers, operating in all Exchange types, that received QRS star ratings for Plan Year 2021. CMS has also released the Quality PUF for Plan Year 2021 that includes star ratings assigned to plans that will be available on HealthCare.gov for Plan Year 2021.
QRS/QHP Enrollee Survey deadlines for issuers
|HHS-approved QHP Enrollee Survey vendor securely submits the QHP Enrollee Survey response data to CMS (on behalf of the QHP issuer).||May 24, 2021|
|QHP issuer submits the validated QRS clinical measure data, with attestation, to CMS via NCQA’s Interactive Data Submission System (IDSS).||June 15, 2021|
|QHP issuers preview the 2021 QHP quality rating information.||August/September 2021|
|QHP issuers submit first round of QIS forms as part of QHP application||June 16, 2021|
|QHP issuers submit final QIS form(s) as part of QHP application (if updates required based on review of first round submission)||August 23, 2021|
Useful Links and Support
Marketplace Quality Initiatives Listserv
Registration for Technical Assistance Portal (REGTAP)
Center for Consumer Information and Insurance Oversight (CCIIO) website:
Qualified Health Plan (QHP) website: