CalOptima Health is required to report Healthcare Effectiveness Data and Information Set (HEDIS) rates to the National Committee for Quality Assurance (NCQA), the Centers for Medicare & Medicaid Services (CMS) and the Department of Health Care Services (DHCS). Medical record review is allowed for a subset of measures known as hybrid measures.
This training contains annual content to help providers and staff understand the specifications and required documentation to meet compliance for each measure while working with CalOptima Health members.