R428-12. Health Data Authority Survey of Enrollees in Health Plans  


R428-12-1. Legal Authority
Latest version.

  This rule is promulgated under authority granted by Title 26, Chapter 33a and in accordance with the Utah Health Plan Performance Measurement Plan.


R428-12-2. Purpose
Latest version.

  This rule establishes the process for the collection of enrollee satisfaction data from Utah carriers that are needed to promote informed consumer choice in plan selection and measure the quality of care provided to enrollees of Utah carriers.


R428-12-3. Submission of Satisfaction Data
Latest version.

  (1) Each carrier covered by the scope determined in subsection R428-12-5 shall compile and submit enrollee satisfaction (Consumer Assessment of Healthcare Providers and Systems survey or CAHPS) data to the Office according to this rule.

  (2) By January 1 of each year, each carrier shall submit to the Office a plan for creating and providing CAHPS data for the preceding calendar year. For each required survey, the plan must clearly indicate whether the carrier will use the Office's contracted vendor or whether the carrier will contract with a survey agency on their own.

  (3) By July 1 of each year, each carrier shall submit to the Office CAHPS data for the preceding calendar year, unless an alternate timeframe has been determined under subsection R428-12-5, in which case the carrier shall submit the data by the alternate due date.


R428-12-4. Sampling Frame Submission
Latest version.

  (1) The sources for enrollment data are Utah carriers. Each carrier shall include in the sampling frame all eligible enrollees.

  (2) Each carrier shall create the sampling frame according to the criteria outlined in the NCQA Survey Specifications.

  (3) The sampling frame and procedures used by the reporting carrier are subject to audit by the Office of Health Care Statistics.

  (4) The carrier shall copy the sampling frame using an electronic medium acceptable to the survey agency and then send to the survey agency.

  (5) The carrier shall fill out the "Sample Description" sheet to be provided by the survey agency and send it with the electronic sample file. Each carrier shall submit to the survey agency the sampling frame for each of its products no later than four weeks after the receipt of the sampling memo from the survey agency.


R428-12-5. Administration of Survey
Latest version.

  Each year, the Utah Department of Health, in consultation with carriers, will determine the target survey population, survey timeframes, and the scope of the survey.