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® 2023 letter to physicians (PDF, 141 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 thcichelp@dshs.texas.gov. 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
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Criteria (PDF, 264 KB) for consideration of exemption from reporting
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