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Frequently Asked Questions

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.

Showing 1 to 10 of 11 results

Do the data elements comprising the falls risk assessment need to be documented as part of a comprehensive assessment?

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.

FAQ ID:88961

Do the components of the risk assessment need to be completed during a single encounter?

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.

FAQ ID:88966

Is a standardized tool required for assessment of balance/gait?

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.

FAQ ID:88971

Can the same standardized tool be used to conduct screening (Part 1) and risk assessment (Part 2)?

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.

FAQ ID:88986

Do the data elements comprising the plan of care to prevent future falls need to be documented as part of a comprehensive care plan?

No. Although a comprehensive care plan may include the elements comprising a plan of care to prevent future falls, the measure does not require the plan of care elements to be documented as part of a comprehensive care plan. For this measure, a plan of care is considered complete if the member record includes any documentation of exercise therapy or referral to exercise between August 1 of the year prior to the measurement year and December 31 of the measurement year.

FAQ ID:88991

Should the rate of required exclusions be reported with the Screening, Risk Assessment, and Plan of Care to Prevent Future Falls measure's Part 2 performance rate?

Yes, the rate of exclusion for members who refused an assessment and/or a plan of care needs to be reported with the measure’s performance rate.

FAQ ID:88996

Can the same sample for Part 2 of the Screening, Risk Assessment, and Plan of Care to Prevent Future Falls measure be used for other measures?

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.

FAQ ID:89001

What is the Office of Management and Budget (OMB) Circular A -87 Exception?

OMB Circular A-87requires costs associated with building shared state-based Information Technology (IT) systems that support multiple health and human service programs be allocated across all benefitting programs in proportion to their use of the system. The OMB A-87 Exception revised this approach by allowing human service programs (e.g. SNAP, TANF, LIHEAP, etc.) and others to utilize a wide range of IT components, needed by Medicaid but also of use to these other programs, at no additional cost except for interfaces or other uniquely required services specific to those programs. The A-87 Exception applies only to design, development, and implementation. Maintenance and operations work should continue to be allocated in accordance with the A-87 Circular. OMB Circular A-87  â€“ Cost Principles for State, Local, and Indian Tribal Governments, has been Relocated to 2 CFR, Part 225 .

FAQ ID:93611

When does the OMB A-87 Exception expire?

On July 20, 2015, the U.S. Department of Health and Human Services and the U.S. Department of Agriculture announced a three-year extension of the Exception to the OMB A-87 cost allocation requirements from December 31, 2015 to December 31, 2018. We are currently making plans for the OMB A-87 exception to end.

FAQ ID:93616

What is the impact of the OMB A-87 expiration for states utilizing the exception for system integration development?

States will need to incur costs for goods and services furnished no later than December 31, 2018 to make use of this Exception. Therefore, if work is completed by December 31, 2018, it can be funded under the OMB A-87 Exception and states should follow typical invoicing and claiming processes. However, if an amount has been obligated by December 31, 2018, but the good or service is not furnished by that date, then such expenditure must be cost allocated by program in proportion to their use of the system in accordance with OMB A-87.

FAQ ID:93621

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