CommercialAdministrativeMedium impact
Hints for HEDIS® – Osteoporosis Management
Blue Cross Blue Shield of Rhode Island·RI · Orthopedics, Family Medicine, Internal Medicine +2 more·Behavioral Health
Effective date
Nov 1, 2022
We identified it
Jun 19, 2026
Summary
BCBSRI updated their HEDIS Osteoporosis Management measure guidelines for women 67-85 who suffered fractures between July 2021-June 2022. The policy requires BMD testing or osteoporosis medication prescription within 6 months post-fracture, with BCBSRI providing monthly fax notifications and support services.
Action Required
Billing team should establish workflow to track BCBSRI fracture notifications via monthly fax and ensure post-fracture follow-up within 6 months. Set EMR reminders for BMD testing or osteoporosis medication prescribing for eligible female patients 67-85. Contact QualityHEDIS@bcbsri.org for questions and coordinate with BCBSRI Quality Concierge Nurse for patient follow-up support.