CMS HEIDS Audits

bgarofalo

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I'm hoping someone can help us with this question. We received 2 separate faxes from Gateway Health Plan (our local Medical Assistance plan) requesting medical records on patients so that they can perform a CMS HEDIS audit. What is concerning about both these requests is the broad timeframe they are using for dates of service. The first request is for records from 2001 to 2010 while the second request is for records from 2002 to 2011.
Can someone please provide us with a guideline per CMS for dates of service that the HEDIS audits are permitted to request? Some of these records could be in an inactive file area while others may not be maintained by the Practice due to our records retention policy.

Thanks in advance for any direction or guidance you can give us.
 

rjdorn

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HEDIS Records

That is quite a broad timeline and the only reason I can think of is the Colorectal Cancer Screening measure specifically a colonoscopy which is good for 10 years. All of the other HEDIS measures have a time frame of every measurement year and/or every two years so records that far back would not be useful.

Rachelle
 
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