We require Federal Employees Health Benefits (FEHB) plans with at least 500 FEHB subscribers (contracts) as of March 31, 2002, to administer a CAHPS^® 3.0H Adult Survey following the HEDIS specifications described in HEDIS 2003, Volume 3: Specifications for Survey Measures. All CAHPS^® surveys have been updated to version 3.0H. Highlights of the changes include: renaming the former Advising Smokers to Quit measure to Medical Assistance With Smoking Cessation; changes to the number, order and wording of survey questions and response options. The sample size for the Adult Commercial Survey has increased from 950 to 1100 members. A copy of the CAHPS^® 3.0H Adult Commercial Questionnaire is included as Appendix A.

To improve FEHB members' ability to compare survey results among various plans and options, we are making available to multiple option plans (i.e., High Option and Standard Option plans) the opportunity to administer and report separate CAHPS^® surveys for each plan option offered under the FEHB Program. Also, to facilitate our members' ability to compare survey results at the local level, we are offering our Fee-for-Service (FFS) plans the option to conduct separate regional, State or local area CAHPS^® surveys. At least one FFS plan has already agreed to conduct regional surveys in 2003, and we look forward to other plans taking advantage of this opportunity.

Additional Instructions and Information:

• All surveys must be administered by an NCQA-certified vendor and must be conducted according to NCQA protocols contained in HEDIS^® 2003, Volume 3: Specifications for Survey Measures. You may order a copy of Volume 3 online through the following link: http://www.ncqa.org/Communications/Publications/epubpricing.htm#HEDIS2.

• We do not require FEHB plans to administer the CAHPS^® 3.0H Child Survey (with or without the CCC measurement set).

• Regardless of the size of your FEHB enrollment, if you conduct any 2003 CAHPS^® Commercial Survey (Adult or Child), you must send us a copy of your survey results and you must meet the reporting deadlines mentioned below.

• You may use an alternative or enhanced protocol or add supplemental questions to the survey with prior NCQA approval.

• Over-sampling (above the required 1100 members) is allowed according to the protocols in Volume 3.

• All Plans must submit their member level data files to NCQA for calculation of survey results and generation of validated member level and summary level data files. Before submitting your results to NCQA, you will need to complete NCQA's Healthcare Organization Questionnaire (HOQ) through NCQA's secured Website. Please contact NCQA's Data Collection department at HOQ@ncqa.org, for help obtaining access to the HOQ. All plans must complete the HOQ to receive a submission ID. User ID's and passwords will be available from NCQA in January 2003. HOQs will be available in early February 2003. NCQA will issue submission ID's in April 2003.

• We require you to provide a Crosswalk file along with your survey results that maps your NCQA submission ID(s) to your FEHB plan name and Sub-Code. The Crosswalk file is due two weeks after NCQA issues submission ID's (see additional information regarding the Crosswalk below).

• June 17, 2003, is the reporting deadline for you to provide your final member-level data files, summary-level data files in NCQA format and crosswalks to our contractor, Office Remedies, Inc. (ORI).

• The OPM data processing fee is $474 per carrier code. Plans that submit data to OPM will be charged the data processing fee regardless of the plans FEHB Program status for 2004.

Public Burden Statement

You must include the following statement on questionnaires you mail to respondents: This information collection has been approved by the U.S. Office of Management and Budget (Control Number 3206-0236) and is in compliance with the Paperwork Reduction Act of 1995. We estimate that it will take an average of 20 minutes to complete, including the time to read instructions and to gather necessary information. You may send comments about our estimate or any suggestions for minimizing respondent burden, reducing completion time or any other aspect of this information collection to the U.S. Office of Personnel Management (OPM), Reports and Forms Officer (OMB Number 3206-0236), Washington, DC 20415-7900. Your participation in this information collection is voluntary. The OMB Number, 3206-0236, is currently valid. OPM may not collect this information, and you are not required to respond, unless this number is displayed. Also, include the following statement in the upper right corner of each questionnaire: Form approved: OMB No. 3206-0236.

Data Collection Vendor

You must use an NCQA-Certified HEDIS Survey Vendor to administer your 3.0H Surveys. You may contract with any NCQA Certified survey vendor. A list of approved vendors is available online at http://www.ncqa.org/Programs/HEDIS/index.htm. Please check the list to verify that your vendor is NCQA Certified to administer HEDIS® 2003 CAHPS^® 3.0H Surveys.

Survey Participation Form

To assist us in tracking nonparticipating plans and plans that will be submitting survey results we require all FEHB plans to complete the enclosed Survey Participation Form (see Appendix B). Regardless of your participation status please complete and return the form to us by December 20, 2002. If you offer more than one FEHB plan or option, please list the name and FEHB Sub-Code (See Appendix C - Sub-Code List) for each plan you offer. Please e-mail the completed form to rpierce@opm.gov or submit the form by facsimile at (202) 606-0036.

Pre-Administration Audit Requirement

Plans seeking NCQA Accreditation and those that intend to include their survey results in NCQA's information products (i.e., Quality Compass®¹) must have their sample frame audited. If your plan is not seeking NCQA Accreditation and you do not intend to publish your survey results in NCQA information products we do not require an audited sample frame. Please contact NCQA's Policy Clarification Support http://www.ncqa.org/programs/faq/PCS.asp, if you have questions about this requirement.

Your vendor must use the CAHPS^® 3.0H questionnaire (see Appendix A). Vendors must administer the survey and report survey results according to the protocols in NCQA's HEDIS^® 2003, Volume 3, Specifications for Survey Measures and subsequent updates. All certified NCQA vendors have copies of HEDIS^® - Volume 3, which includes the survey instruments and protocols.

Membership Data & Sample Frame

Please work closely with your vendor to draw the appropriate sample frame for your survey. HMO and POS plans must draw the sample according to NCQA protocols. Fee-for-Service (FFS) plans must also follow the NCQA protocols for drawing the sample frame with one exception. FFS plans must draw the sample frame from all currently enrolled FEHB members, regardless of their Medicare status.

Crosswalk

When your vendor submits member level and summary level data to OPM, they will need to provide a Crosswalk file to identify plan data submissions. The Crosswalk will allow us to match up NCQA submission ID's with your plan's unique FEHB Sub-Code. Also, the Crosswalk will identify plans that are sharing survey data. Appendix C contains a list of FEHB plans and their unique Sub-Codes.

The Crosswalk file must include the names of the plan(s) that you will survey, the State(s) in which the plan provide services and the plan's FEHB Sub-Code (See Appendix D for an example of what the Crosswalk should look like). The file includes: member level file name, summary level file name and the plan's NCQA Sub-ID. A Crosswalk must accompany each data submission to OPM. Please direct questions regarding the Crosswalk to: Paul Kallaur or Nina Smith with the Center for the Study of Service at (202) 454-3030 or (202) 454-3042, or by e-mail at: pkallaur@cssresearch.org or nsmith@cssresearch.org.

Your vendor must submit CAHPS^® 3.0H member level data files to NCQA according to NCQA's Adult Survey File Specifications and Layouts. To ensure consistency and comparability of survey results we require all plans to submit their member level data files to NCQA for calculation of survey results through their vendor. NCQA will calculate survey results and create validated member level data files and summary level data files on behalf of vendors. Although the final Security Rule has not been published as of the date of this letter, we expect all FEHB plans to be compliant with HIPAA's privacy rules, using appropriate encryption technology to transmit survey data.

We will accept your member level data files and summary level data files after they have been processed by NCQA. Your vendor may submit data via e-mail, diskette or compact disc (CD). You may include results for multiple plans on a single diskette or CD. All submission must include a content label/sheet and a Crosswalk. Please direct questions regarding data files to Sue Lynd or Carla Trexler with ORI at (703) 478-0910. Please send all data files to ORI via e-mail at oridata@aol.com or by overnight mail to:

ORI
Attention: Sue Lynd
171 Elden Street
Suite 160
Herndon, VA 20170

Processing Fee

Each plan participating in the survey will be responsible for a pro rata share of the total cost of compiling, processing and reporting survey data to OPM. The 2003 processing fee is $474 per carrier code. ORI will send you an invoice for the data processing fee. The fees are payable directly to ORI and will be due on June 17, 2003. If a plan decides to withdraw from the FEHB Program after submitting CAHPS® data to OPM, the plan is still liable for the processing fee.

Reporting Deadlines

All materials must be received by the following deadlines:

• December 20, 2002 - Survey Participation Form (all FEHB Plans must complete this form)

• April 15, 2003 (tentative) Crosswalk file (due two weeks after NCQA issues your submission ID(s)

• June 17, 2003 - Member level data file and final summary level data files (must be NCQA validated)

We are pleased to provide these guidelines and instructions for submitting your 2003 CAHPS® survey results. If you have any questions you may contact Ralph Pierce by e-mail at rpierce@opm.gov or by telephone at (202) 606-2758.

Sincerely, Abby L. Block Assistant Director    for Insurance Programs

Enclosures

1. - CAHPS® 3.0H Adult Commercial Questionnaire (Word file)
2. - Survey Participation Form (Word file)
3. - FEHB Sub-codes (Excel file)
4. - Sample Crosswalk(Word file)

Download this Letter as a PDF File (106K File)