CommercialAdministrativeMedium impact
Hints for HEDIS® (and more)
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Rheumatology·Physician
Effective date
Jul 1, 2020
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island has updated their HEDIS quality measure guidance, adding Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis (ART) to their 2020 Physician Quality Incentive Program. Providers must ensure proper RA diagnosis coding and DMARD prescribing documentation to meet quality metrics and avoid incorrect patient inclusion in gap-in-care reports.
Action Required
Review monthly Gap in Care reports for RA patients. Verify accuracy of rheumatoid arthritis diagnosis coding and submit correction forms if RA was coded in error. Document DMARD prescriptions and specialist consultations in primary care records. Contact Quality Concierge Team at QualityHEDIS@bcbsri.org or (401) 459-1005 for support with gap closure reporting.