Frequently Asked Questions are used to provide additional information and/or statutory guidance not found in State Medicaid Director Letters, State Health Official Letters, or CMCS Informational Bulletins. The different sets of FAQs as originally released can be accessed below.
Frequently Asked Questions
No, the sample for Part 2 of the Screening, Risk Assessment, and Plan of Care to Prevent Future Falls measure is different from the systematic sample used for the LTSS Comprehensive Assessment and Update, LTSS Comprehensive Care Plan and Update, LTSS Shared Care Plan with Primary Care Practitioner, and Part 1 of the Screening, Risk Assessment, and Plan of Care to Prevent Future Falls measures. Members included in the sample for Part 2 of this measure must have a documented history of falls (at least two falls or one fall with injury in the past year), including documentation of plan member self-reported history of falls.
Date: March 1, 2019
Topics:
Managed Long Term Services and Supports (MLTSS)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls
Subtopics:
Falls Part 2 (Risk Assessment and Plan of Care)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls: Falls Part 2 (Risk Assessment and Plan of Care)
FAQ ID: 89001
The measure excludes plan members who are not ambulatory from the measure rate, but it is not necessary to report the number of members excluded with the measure’s performance rate.
Date: March 1, 2019
Topics:
Managed Long Term Services and Supports (MLTSS)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls
Subtopics:
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls: Falls Part 1 (Screening)
FAQ ID: 89006
No, a specific screening tool is not required for this measure. However, potential screening tools may include the Morse Fall Scale and timed Get-Up-And-Go test.
Date: March 1, 2019
Topics:
Managed Long Term Services and Supports (MLTSS)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls
Subtopics:
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls: Falls Part 1 (Screening)
FAQ ID: 89011
A falls screening is an evaluation of whether a Managed Long Term Services and Supports plan member has experienced a history of falls and/or problems with balance or gait. A falls risk assessment includes a balance/gait assessment and one other assessment component and should only be performed for members with a documented history of falls (at least two falls or one fall with injury in the past year).
Date: March 1, 2019
Topics:
Managed Long Term Services and Supports (MLTSS)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls
Subtopics:
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls: Falls Part 1 (Screening)
FAQ ID: 89016
The technical specifications and webinar materials for these measures are available on the MLTSS page:
Date: March 1, 2019
Topics:
MLTSS general FAQs
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89021
If you have additional questions about these measures, please submit your question to the technical assistance mailbox at MLTSSmeasures@cms.hhs.gov for assistance.
Date: March 1, 2019
Topics:
MLTSS general FAQs
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89026
As more states shift to MLTSS and gain more experience, the need to measure program outcomes and quality has increased. The new quality measures, which were carefully designed for beneficiaries enrolled in MLTSS plans, represent a major step forward in giving the Centers for Medicare & Medicaid Services (CMS), states, MLTSS plans, providers, and consumers the ability to compare the performance of MLTSS programs and plans within and across states. Specifically, CMS wanted to create nationally-standardized measures meeting importance, usability, feasibility, and scientific validity and reliability standards for use across MLTSS plans and state Medicaid programs to fill key gaps in MLTSS measure domains while not duplicating other measures that have been developed or are currently under development.
Date: March 1, 2019
Topics:
MLTSS general FAQs
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89031
No, CMS does not require states or MLTSS plans to report these measures. However, states may choose to require plans to report any of these measures to the state Medicaid agency.
Date: March 1, 2019
Topics:
MLTSS general FAQs
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89036
Through our discussions with MLTSS plans, we learned that plans—particularly those operating in multiple states—can ease the burden of data collection by mapping their existing assessment and care plan tools to the standardized data elements and terminology in these measures, which would make it easier to abstract data and standardize the data collection process. It is also important for MLTSS plan managers to train staff to document assessment and care plan elements consistently, as well as train individuals responsible for collecting data on how to interpret each of the elements specified in each measure. Plans can also ease the burden of data collection by ensuring data from multiple sources are consolidated into a central data system.
Date: March 1, 2019
Topics:
MLTSS general FAQs
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89041
If MLTSS plans report measure rates directly to the state, the state should conduct an independent review of a sample of members included in the reported measures, for example, by the External Quality Review Organization or state-employed abstractors.
Date: March 1, 2019
Topics:
MLTSS general FAQs
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89051