Why this matters now
NCQA releases HEDIS® Measurement Year 2027 Volume 2: Technical Specifications for Health Plans on August 3, 2026, along with the MY 2027 specifications for long-term services and supports measures. Quality teams get their first full look at the measure set they will live with through the 2027 season. The notification of changes and public comment materials already outline where the program is headed, so you have a two-week head start.
What NCQA has confirmed
Several changes arrive independent of public comment:
- Cervical Cancer Screening (CCS-E): The MY 2026 Technical Update expands the high-risk HPV lab test value set to include self-collected vaginal samples, following updated American Cancer Society screening guidelines.
- Social Need Screening and Intervention (SNS-E): NCQA removed HCPCS code G0136 from the screening numerators after CMS redefined the code in the CY 2026 Physician Fee Schedule. The measure now relies on LOINC codes for standardized screenings.
- LTSS measure template: The format moves to FHIR-aligned standards, another step toward interoperable, digital HEDIS® measurement. Measure intent and data collection requirements stay the same.
- Hybrid timeline updates: NCQA confirmed revised, measure-specific pathways for retiring the hybrid method by MY 2029, covered in detail in our companion article on the hybrid retirement countdown.
The proposed new measures
Two proposed measures drew attention during the MY 2027 public comment period:
- Continuous Glucose Monitoring Utilization for Patients With Diabetes (CGD-E) assesses CGM use among members with diabetes, reflecting the technology's role in preventing hypoglycemic and hyperglycemic events.
- Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test (COF-E) assesses the percentage of adults ages 45 to 85 who received a colonoscopy within 180 days of a positive non-invasive screening result.
The August 3 release confirms which proposals made the final specifications and in what form.
Watch the denied claims change
Buried in the advance notice sits a change with real rate impact. Beginning MY 2028, NCQA will remove the exclusion of denied claims from 21 measures spanning overuse, utilization, and risk-adjusted utilization, including Use of Opioids at High Dosage, Plan All-Cause Readmissions, and Emergency Department Utilization. NCQA's rationale: excluding denied claims inflates performance and hides care members received and paid for. Expect rates to move on these measures with no underlying change in care. Model the impact early.
What this means for health plans
Both proposed measures follow the ECDS-first pattern, a signal every new HEDIS® measure will assume electronic data from day one. The CGM measure rewards plans with strong pharmacy and device data integration. The colorectal follow-up measure tests whether your systems connect a positive screening result to a completed colonoscopy across care settings, a classic data linkage challenge.
Practical takeaways
- Put August 3 on your quality team's calendar and schedule a specification review within the first week.
- Assess your CGM data sources now, including pharmacy claims, DME claims, and device feeds.
- Test your ability to track colonoscopy completion after positive non-invasive screenings, in and out of network.
- Run a MY 2028 impact model on the denied claims change for the 21 affected measures.
Questions to consider
Which of your data feeds support the new ECDS-first measures? How will the denied claims change reshape your utilization measure rates? Does your roadmap treat each new specification release as a one-off project or as part of a digital strategy?
The 16th Annual HEDIS® & Quality Improvement Summit, November 3-5, 2026 in Baltimore, gives quality leaders three days to compare notes on the new specifications, ECDS operations, and the transition to digital measurement.
HEDIS® is a registered trademark of the National Committee of Quality Assurance (NCQA) and any reference thereto by RISE Health does not imply any endorsement by NCQA of RISE Health and its offerings.