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FAQs

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The PQA Measure Manual includes some implementation guidelines around pharmacy-patient attribution, level of attribution, small sample sizes, risk adjustment, etc. Moreoever, many of our measures are tested at the plan level. So, they must be tested at the level of attribution (i.e. prescriber or pharmacy) before using them in the program.
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We have reviewed and determined that type of service code 35 should NOT be part of the criteria. You can disregard this code. We will update the hospice criteria in a future release.
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This criteria is broadly applicable to all of our measures, but where we don’t allow for gaps, it is not ideal and enrollment data is much preferred.
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General

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