ATLANTA — LexisNexis Risk Solutions announced that in December 2018 it met the requirements to become a Certified Qualified Entity (QE) under the Centers for Medicare & Medicaid Services’ (CMS) Qualified Entity Certification Program. Based on the volume of LexisNexis Risk Solutions’ claims data and other requirements, LexisNexis is recognized as a QE for the 50 states of the US and the District of Columbia.
The CMS Qualified Entity Program (also known as the Medicare Data Sharing for Performance Measurement Program) enables organizations to receive Medicare Parts A and B medical claims data and Part D prescription drug claims data for use in evaluating provider performance. Organizations approved as QEs are required to use the Medicare data to produce and publicly disseminate CMSapproved reports on provider performance.
“We are excited to have been granted a QE status validating our experience combining multiple claims data sources, rigorous data security and privacy programs. Collaborating with the CMS will advance our efforts in accurately measuring and improving the quality, efficiency, and effectiveness of provider performance in the U.S. healthcare system,” said Josh Schoeller, senior vice president and General Manager of LexisNexis Risk Solutions, Health Care. “We look forward to working with CMS to support its charter through the QE program to improve the quality of provider performance, increase transparency in healthcare performance, provide information for employers and consumer groups to assist them in making more informed healthcare decisions, and spur innovation in the area of performance measurement,” he added.
LexisNexis Risk Solutions offers health plans, providers, life sciences organizations, Pharmacy Benefit Management companies and pharmacies a robust suite of solutions that combine trusted provider data sources, claims data and patient insights to drive better outcomes, efficiency and compliance. The ability to integrate Medicare Parts A and B claims data and Part D prescription drug event data from CMS will help accelerate innovation to drive better provider performance and patient analytics. For additional information, please see Provider Data Quality.
About LexisNexis Risk Solutions
LexisNexis Risk Solutions harnesses the power of data and advanced analytics to provide insights that help businesses and governmental entities reduce risk and improve decisions to benefit people around the globe. We provide data and technology solutions for a wide range of industries including insurance, financial services, healthcare and government. Headquartered in metro Atlanta, Georgia, we have offices throughout the world and are part of RELX (LSE: REL/NYSE: RELX), a global provider of information and analytics for professional and business customers. For more information, please visit www.risk.lexisnexis.com and www.relx.com.