Quality Improvement
All issuers offering QHPs
through the Exchanges that meet the Quality Improvement Strategy (QIS)
participation criteria must comply with the QIS requirements as a condition of
certification and participation in the Exchanges. CMS annually publishes the
QIS Technical Guidance and User Guide, a detailed guide to the QIS
requirements, and the QIS Implementation Plan form, Progress Report form, and
Modification Summary Supplement form, which are the QIS reporting tools for issuers
applying for QHP certification.
QIS Materials for the 2025 Plan Year
The QIS materials for the 2025 plan year are now available for issuer to download from the Marketplace Quality Initiatives (MQI) website.
- The QIS Issuer List for the 2025 Plan Year includes
issuers operating in Federally-facilitated Exchanges (FFEs) and FFEs where
states perform plan management that meet the QIS participation criteria
and are required to implement and report on at least one QIS as a
condition of QHP certification for the 2025 plan year.
- The QIS Implementation Plan form, Progress
Report form and Modification Summary Supplement form for the 2025 Plan Year
(QIS Forms) collect QIS information from issuers in order to
demonstrate compliance with section 1311(c)(1)(E) of the Patient
Protection and Affordable Care Act. Please note that issuers may use the draft Plan Year 2025 QIS forms that are available on the Marketplace Quality Initiatives (MQI) website to report their QIS information this year.
- The QIS Technical Guidance and User Guide for
the 2025 Plan Year communicates finalized QIS requirements and
instructions for how to complete the QIS form.
Issuers should submit
questions about QIS to the Marketplace Service Desk (MSD) by phone at
1-855-CMS-1515 (1-855-267-1515) or by email at CMS_FEPS@cms.hhs.gov. When submitting inquiries via email, please include
"MQI-QIS" and your HIOS Issuer ID in the subject line or body of the
email.