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. Although a comprehensive assessment may include falls risk assessment elements, this measure does not require the risk assessment elements to be documented as part of a comprehensive assessment. For this measure, a falls risk assessment is considered complete if the member record includes any documentation of a balance/gait assessment, and documentation of assessment of postural blood pressure, vision, home fall hazards, and/or medications.
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: 88961
No, the components can be completed during separate encounters, provided they are documented in the member record as having been performed between August 1 of the year prior to the measurement year and December 31 of the measurement 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:
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: 88966
No, a standardized tool is not required, although documentation of use of a standardized tool (for example, Get Up & Go, Berg, Tinetti) would meet the balance/gait assessment component of the measure.
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: 88971
Yes, the same tool may be used to conduct the screening and risk assessment for the Screening, Risk Assessment, and Plan of Care to Prevent Future Falls measure.
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: 88986
No. MLTSS plans are not required to share the full care plan with the PCP or other documented medical care practitioner. MLTSS plans may choose which parts of the care plan are most relevant to the practitioner.
Date: March 1, 2019
Topics:
LTSS Shared Care Plan with Primary Care Practitioner (PCP)
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89221
No, the LTSS Shared Care Plan with Primary Care Practitioner (PCP) measure only looks to see that a care plan was sent to a primary care practitioner (PCP) by the MLTSS plan. No signature from the PCP is necessary to count towards the numerator of this measure.
Date: March 1, 2019
Topics:
LTSS Shared Care Plan with Primary Care Practitioner (PCP)
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89226
There is no need for a release of information. If a member gives the plan the contact information for their PCP, the plan can share information with that PCP. Plans or other providers of LTSS should try to coordinate LTSS services with medical services, even if they are not the primary payer for medical services for the member. Plans that do not know the member’s PCP can/should ask the member to identify their PCP and request their contact information. The measure is intended to determine whether plans tried to connect with the medical care provider. There is an exclusion in this measure for members who refuse to have their care plan shared with the PCP, so if the member refuses, this should be documented, and such members are excluded from the measure rate.
Date: March 1, 2019
Topics:
LTSS Shared Care Plan with Primary Care Practitioner (PCP)
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89231
No; discharges for planned hospital admissions are excluded from the measure denominator. Identify planned discharges using the value sets.
Date: March 1, 2019
Topics:
LTSS Reassessment/Care Plan Update after Inpatient Discharge
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89236
Yes, both the re-assessment and the care plan must include each of the nine specified core elements. The re-assessment and care plan must be done face-to-face unless there is documentation that the member refused a face-to-face encounter.
Date: March 1, 2019
Topics:
LTSS Reassessment/Care Plan Update after Inpatient Discharge
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89241
The denominator for the Reassessment/Care Plan Update after Inpatient Discharge measure is identified through administrative claims for inpatient discharges. Managed care plans that are not the primary payer for inpatient care, which is usually covered under a medical benefit, do not routinely have reliable access to administrative claims for inpatient stays to identify individuals who are eligible to be counted in the measure denominator. Therefore, the eligible population for this measure is restricted to individuals who receive both medical and LTSS benefits through the managed care plan providing MLTSS.
Date: March 1, 2019
Topics:
LTSS Reassessment/Care Plan Update after Inpatient Discharge
Managed Long Term Services and Supports (MLTSS)
FAQ ID: 89246