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Frequently Asked Questions (FAQs) About NCQA's Accreditation, Certification and HEDIS®.

New FAQs are posted on the 15th of every month.
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Product: WHP 2009

MISC   Look-back period
    Question: The look-back period for most file review elements indicates that the activities must be completed during the 12 or 24 month look-back period. What does "during" mean?
    Resolution: "During" means that unless otherwise noted, organizations must meet the requirement throughout the look-back period.
WHP   Meaning of “capability to perform”
    Question: Define "capability to perform." Is a documented process enough to demonstrate this?
    Resolution: "Capability to perform" means that an organization demonstrates the ability to carry out the required activity through documentation and at least one example of actually conducting the activity for at least one client. The example must reflect how the organization performs the activities for all clients that purchase it.
WHP3   Opportunities for Engagement and Activities
    Question: What are “opportunities for engagement and activities”?
    Resolution: Programs or services that support eligible individuals in engaging in or maintaining healthy behaviors and reducing health risks (e.g., fitness classes or walking clubs, stretch breaks during meetings, workday wellness breaks, weight loss programs, smoking cessation support groups, incentive programs or competitions). Opportunities for engagement and activities are interactive.
WHP3   Difference in WHP 3, Element E and WHP 6: Self-Management Tools
    Question: Why does WHP 6 address self-management tools, if this is covered in WHP 3, Element E?
    Resolution: For WHP 3, Element E, NCQA just evaluates whether an organization makes self-management tools available to the entire population. For WHP 6, NCQA assesses the content of the tools and how the organization tests, reviews and updates, and offers the tools.
WHP3   Services to Increase Health Awareness
    Question: What are “services to increase health awareness and skills”?
    Resolution: Assistance or materials (e.g., brochures, handouts, newsletters, educational posters) that educate eligible individuals about their health or give them information about changing health behaviors. Services to increase health awareness and skills typically are not interactive.
WHP4   GINA legislation: family health history on the health appraisal (HA)
    Question: Will NCQA change any requirements as a result of GINA legislation?
    Resolution: Yes. Questions about family health history are no longer required on HAs as of December 7, 2009.
WHP4   Web site print capability
    Question: Where NCQA requires the capability to print information from a Web site, would a screen shot suffice that the required information can be printed from?
    Resolution: No. The organization needs to provide a print function so that the recipient of the information is able obtain a printer-friendly version of the information; a screen shot alone would not suffice.
WHP4   Definition of "current treatment"
    Question: Define "current treatment."
    Resolution: ”Current treatment” is an active course of treatment for an illness or disorder that a participant is presently undergoing. It usually involves monitoring of a condition and any treatment, including prescription or OTC medications that a participant receives.
WHP4   Definition of "reference information"
    Question: Define "reference information."
    Resolution: "Reference information" refers to resources that can help participants understand their HA results and adopt healthier behaviors (e.g., relevant online sources, materials, community or affinity programs). HA results must include references to relevant resources.
WHP6   “In-print” format
    Question: Is including a “print” option in an online document enough to meet NCQA's "in print" requirement?
    Resolution: No. By “in print,” NCQA means a printed copy of a document that is made available (e.g., by mail) to eligible individuals who may not have access to the Internet.
WHP7   Health Coaching
    Question: What is “health coaching”?
    Resolution: Ongoing and personalized interactive support that promotes healthy changes in behavior and lifestyle and involves multiple interactions which include setting goals to change behaviors and improve health; offering helpful resources or referral advice; and providing follow-up and tracking systems to assess progress. A service is not considered to be health coaching if participants do not interact with a health coach (via an online service, such as instant messaging, or by e-mail, telephone or in person).

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