Fla. Admin. Code Ann. R. 59B-14.004 - Satisfaction Survey Reporting Requirements
(1) Beginning July 1, 2006, health insurers
shall report annual survey data using the Consumer Assessment of Health Plans
(CAHPS) questionnaire of the National Committee for Quality Assurance (NCQA)
and supplemental questions described in paragraphs (a), (b) and (c) below to
the Agency for Health Care Administration (agency) performed for a random
sample of Florida insureds fielded during the first half of the year following
the measurement year except that health insurers defined under Chapter 627,
F.S., shall report selected CAHPS data to include health plan customer service,
health plan claims processing, obtaining information about the health plan,
overall satisfaction with the health plan, age of insured, gender of insured,
health status of insured, race of insured, level of education of insured,
ethnic group of insured and the supplemental questions described in paragraphs
(a), (b) and (c) of this subsection. The data shall be submitted with an
acceptable audit report as provided in subsection (6) below.
(a) Would you recommend your health plan to
your family or friends?
1. Definitely
yes;
2. Probably yes;
3. Probably not;
4. Definitely not.
(b) How would you rate the number of doctors
you had to choose from?
1.
Excellent;
2. Very good;
3. Good;
4. Fair;
5. Poor;
6. No experience.
(c) If today you could select any health plan
company in your area, would you select your current plan again?
1. Definitely yes;
2. Probably yes;
3. Uncertain;
4. Probably not;
5. Definitely
not.
(2) Health
insurers shall use the most current version of the NCQA CAHPS questionnaire
available on the effective date of this rule to perform the member satisfaction
survey. The NCQA CAHPS questionnaire may be obtained by contacting the National
Committee for Quality Assurance at: www.ncqa.org.
(3) The survey shall be performed for adults
18 years and older.
(4) Health
insurers shall perform a separate member satisfaction survey for the following
plan types (a) and (b) if the number of covered lives exceeds 5, 000 for all
plans within each type:
(a) Health plans of
health maintenance organizations as defined under Chapter 641, F.S.;
and,
(b) Health plans of health
insurers defined under Chapter 627, F.S.
(5) Health insurers shall administer the
survey in a manner that meets or exceeds the survey protocol standards of the
National Committee for Quality Assurance (NCQA) as set forth in the most
current version of the Specifications for Survey Measures available on the
effective date of this rule. The Specifications for Survey Measures may be
obtained by contacting NCQA at: www.ncqa.org.
The required final sample size submitted to the agency must equal or exceed 411
surveys except that a health insurer with less than 20, 000 covered lives in
Florida will not be penalized if the health insurer can document that the
survey was administered according to the NCQA survey protocol.
(6) Health insurers shall report the name of
the survey vendor and the auditor, if any, as specified in Rule
59B-14.006, F.A.C.
(7) The survey data shall be submitted to the
agency in a text file in the order of survey questions in the adjunct file
described in subsection (8), using a tab between each data element and starting
a new line for each respondent.
(8)
Health insurers shall report a separate adjunct text file to the agency
containing contact information and survey questions for each plan type
reported. Report the survey questions in the adjunct file in the order
administered, starting a new line for each question. Include the health plan
contact information required in Rule
59B-14.006, F.A.C., at the
beginning of the adjunct file followed by the survey questions. Report health
plan contact information in the order specified in Rule
59B-14.006, F.A.C., using four
lines of text starting a new line beginning with contact name, survey vendor
name and auditor name.
(9) Health
insurers shall submit the CAHPS survey data annually to the National CAHPS
Benchmarking Database (NCBD) according to the specifications provided on the
NCDB website: http://ncbd.cahps.org/Home/Index.asp.
Each health insurer will permit the NCBD to release the data to the agency
provided that the data is released in a manner that does not or could not be
used to identify specific health insurers. Health insurers will retain
ownership of the data submitted to and maintained by the
NCBD.
Notes
Rulemaking Authority 408.15(8) FS. Law Implemented 408.061(1)(c), (e) FS.
New 12-25-05.
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