Health Maintenance Organization (HMO) Data Reporting Requirements

Texas Health Care Information Collection
Center for Health Statistics

Who Needs to Report

Commercial Product Basic Service HMOs (PDF, 308 KB) are required to report Texas’ subset of HEDIS® 2023 (2022 data) by service area. The requirement for reporting is based on enrollment numbers as of December 31, 2021.

What Measures to Report

THCIC expects the Texas Subset of HEDIS® 2023 (PDF, 118 KB) HEIDIS to be reported for the 2022 data year and HEDIS® 2024 Letter to Physicians (PDF, 88 KB). 

When, where and how to report

  • Commercial
    THCIC has contract with NCQA to collect and process the required Texas subset of HEDIS® 2022 Data for the state and the submission guidelines.

    On or before June 15 HMOs must also provide copies of the completed NCQA Interactive Data Submission System (IDSS), the Audit Designation (Review) Table and the Final Audit Statement directly to THCIC.  Electronic copies are preferred. Email to  Paper copies can be mailed to:
  • Lead Data Analyst, Texas Health Care Information Collection
    DSHS - Center for Health Statistics, Mail Code -1898
    PO Box 149347
    Austin, TX 78714-9909
    Phone: 512-776-7261
    Fax: 512-776-7740
  • Medicaid
    THCIC will not collect any data from Medicaid HMOs for HEDIS® 2022.
  • CHIP
    THCIC will not collect any data from CHIP HMOs for HEDIS®2022.
  • Medicare
    THCIC will not collect any data from Medicare HMOs for HEDIS® 2022.

Exemption from HEDIS® Reporting

  • Criteria (PDF, 264 KB) for consideration of exemption from reporting

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