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Health Insurance Marketplace Quality Initiatives

Spotlight News

QRS:

  • CMS requests comment on proposed refinements to the QRS and QHP Enrollee Survey included in the Draft 2020 Call Letter for the Quality Rating System and the Qualified Health Plan Enrollee Experience Survey (PDF)CMS encourages interested parties to submit comments to Marketplace_Quality@cms.hhs.gov and reference “Marketplace Quality Initiatives (MQI)-Draft 2020 QRS Call Letter” in the subject line by the close of the comment period (May 20, 2020).

  • CMS has posted the Plan Year 2020 Nationwide Quality Rating System PUF (ZIP) which includes 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 2020. CMS has also posted a Quality PUF (ZIP) that includes star ratings assigned to plans that will be available on HealthCare.gov for Plan Year 2020.  CMS has released the Health Insurance Exchanges QRS Program for Plan Year 2020: Results At-A-Glance (PDF),  which summarizes the QRS ratings for the 2020 Plan Year, including a summary of QRS reporting and QRS scoring eligibility for the 2020 Plan Year.

  • CMS has posted the 2020 Quality Rating System Measure Technical Specifications (PDF), which includes the measure specifications and guidelines for data collection for the 2020 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 QRS 2020 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."

  • CMS has posted the Plan Year 2019 Nationwide Quality Rating System PUF (ZIP) which includes 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 2019. The nationwide QRS PUF is primarily intended for researchers, but may also be used by consumer groups, states or other entities. CMS intends to provide a similar nationwide QRS PUF on an annual basis and to promote transparency of data to the public. CMS has also posted the Health Insurance Exchanges QRS Program for Plan Year 2019: Results At-A-Glance (PDF), which summarizes the QRS ratings for the 2019 Plan Year, including a summary of QRS reporting and QRS scoring eligibility for the 2019 Plan Year.
  • CMS has posted the Quality Rating System and Qualified Health Plan Enrollee Experience Survey: Technical Guidance for 2020 (PDF). QHP issuers certified to offer coverage through the Exchanges in 2020 are required to comply with QRS and QHP Enrollee Survey requirements as a condition of certification. QHP issuers with questions regarding the QRS or the QHP Enrollee Survey should contact the CMS Marketplace Service Desk (MSD) (CMS_FEPS@cms.hhs.gov) and reference the Marketplace Quality Initiatives or "MQI-QRS.”

  • CMS released the Quality Rating Information Bulletin (PDF) to announce that public display of quality rating information by all Exchanges, including Federally-facilitated Exchanges (FFE), inclusive of FFE states where the state performs plan management functions, State-based Exchanges on the Federal Platform (SBE-FPs), and State-based Exchanges (SBEs) that do not use HealthCare.gov will begin during the Open Enrollment Period (OEP) for the 2020 Plan Year.

QHP Survey:

  • CMS has posted the Qualified Health Plan Enrollee Experience Survey: Technical Specifications for 2020 and the templates for 2020 Survey Materials.

  • CMS has posted a frequently asked questions (FAQ) document for the 2020 QHP Enrollee Survey Sample Frame Reporting Requirements here (PDF).

QIS:

  • In response to COVID-19, CMS has announced it is suspending its schedule for collecting quality improvement information for the 2021 Quality Improvement Strategy (QIS) program. While issuers on this list are not required to submit data, the Plan Year 2021 Issuer List as well as the 2021 Plan Year QIS Participation Criteria Fact Sheet (PDF) have been made available as a resource for issuers who may be unsure of their status with regards to QIS, as well as to assist issuers in tracking whether they will be required to submit a QIS Progress Report or Implementation Form in Plan Year 2022. Issuers should review the Draft Plan Year 2021 Issuer List (XLSX) to verify their information and communicate any discrepancies to CMS by emailingCMS_FEPS@cms.hhs.gov with “QIS Issuer List” in the subject line no later than Friday, May 8th.
  • QHP issuers with QIS questions that do not involve the issuer list should contact the Marketplace Service Desk (MSD) Help Desk and reference the Marketplace Quality Initiatives or "MQI-QIS."

Upcoming Deadlines and Events

 
QRS/QHP Enrollee Survey deadlines for issuers
Future Dates TBD TBD
QIS deadlines
Comments on Plan Year 2021 Draft Issuer List and 2021 Plan Year QIS Participation Criteria Fact Sheet due May 8, 2020

Resources

Marketplace Quality Initiatives Listserv
We encourage you to let others know about the CMS Marketplace Quality Initiatives, and to share its messages. Subscribe to Marketplace Quality Initiatives Listserv to be included in future communications and updates.

 Marketplace Service Help Desk (MSD) (reference “Marketplace Quality Initiatives”):
CMS_FEPS@cms.hhs.gov or 1-855-CMS-1515 (1-855-267-1515)

Registration for Technical Assistance Portal (REGTAP)
http://REGTAP.info

Center for Consumer Information and Insurance Oversight (CCIIO) website:

/cciio/

 

Page Last Modified:
05/21/2020 02:58 PM