Fla. Admin. Code R. 59B-14.004
Current through Reg. 50, No. 235-239, December 10, 2024
Section 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?(b) How would you rate the number of doctors you had to choose from?(c) If today you could select any health plan company in your area, would you select your current plan again? (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.Fla. Admin. Code Ann. R. 59B-14.004
Rulemaking Authority 408.15(8) FS. Law Implemented 408.061(1)(c), (e) FS.