Federal Employee Program Annual Medical Record Data Collection for HEDIS Quality Reporting

Blue Cross and Blue Shield Federal Employee Program (FEP) collects performance data using specifications published by the National Committee for Quality Assurance (NCQA) for Healthcare Effectiveness Data and Information Set (HEDIS^®). HEDIS is the most widely used and nationally accepted effectiveness of care measurement available and used for Federal Employees Health Benefits Program (FEHBP).

To meet this annual quality reporting requirement, BCBS FEP will be collecting medical records using internal resources and leveraging an independently contracted third-party vendor Episource. The FEP Quality Reporting for HEDIS Measurement Year (MY) 2021 medical retrieval process will begin in February and run through April 2022.

If you receive a request for medical records, we encourage you to reply within 5 business days. BCBS FEP or the vendor referenced above may be contacting your office or facility in February 2022 to identify a key contact person and to ascertain which data collection method your office or facility prefers (fax, secure email, sFTP (secure file transfer protocol) or onsite). Appointments for onsite visits will be scheduled with your staff, if applicable. You will then receive a letter outlining the information that is being requested, and the medical record request list with members’ names and the identified measures that will be reviewed.

Patient authorization for release of medical record data is not required. These reporting activities are considered health care operations under the Health Information Portability and Accountability Act (HIPAA) of 1996 and its implementing regulations (45 C.F.R. Parts 160 and164), and the Health Information Technology for Economic and Clinical Health (HITECH) Act, as incorporated in the American Recovery and Reinvestment Act (ARRA) of 2009, and its implementing regulations, each as issued and amended.

We appreciate your time and continued collaboration. If you have any questions about medical record requests, please contact the BCBS FEP QI (HEDIS) Department at 1-(888) 907-7918.

HEDIS is a registered trademark of NCQA.

Episource LLC is an independent third-party vendor that is solely responsible for the products or services they offer. BCBS FEP makes no endorsement, representations or warranties regarding any products or services offered by independent third-party vendor. If you have any questions regarding the services they offer, you should contact the vendor directly.