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 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
Are there exclusions for the Long Term Services and Supports Admission to an Institution from the Community measure's eligible population (denominator)?
No. However, when identifying the measure’s denominator from the eligible population, there are a few cases in which you should not include member months. For example, do not include months when the plan member was residing in an institutional facility for the entire month (that is, there were no days in the month spent residing in the community). If a member died, do not include the month during which the member died and any subsequent months of enrollment in the measure’s denominator.
Are there exclusions for the Long Term Services and Supports Admission to an Institution from the Community measure's numerator?
When calculating the measure’s numerator (number of admissions to an institution), do not include admissions that are direct transfers from another institution, admissions from the hospital that originated from an institution, or admissions for individuals who do not meet the continuous enrollment criteria. If the member’s admission resulted in death in the institution or death within one day of discharge from the institution, do not include the admission in the numerator.
Can the community residence include assisted living?
Yes, people admitted to an institution who were residing in the community prior to their admission may include those residing in assisted living, adult foster care, or another setting that is not defined as an institution.
Is the Long Term Services and Supports Admission to an Institution from the Community measure risk-adjusted?
Yes, this measure is risk-adjusted, using risk stratification by age. Results are reported separately for four age groups (18-64, 65-74, 75-84, 85 and older) for each of the length of stay classifications (short-term stay, medium-term stay, and long-term stay).
What is reuse?
The Centers for Medicare & Medicaid Services expects states receiving Federal Financial Participation to share with other states project artifacts, documents and other related materials, and systems components and code for leverage and reuse.
Read the state Medicaid director letter (SMD #18-005) on reuse (PDF, 70.77 KB). Reuse can be accomplished through sharing or acquiring:
- An entire set of business services or systems, including shared hosting of a system or shared acquisition and management of a turnkey service
- A complete business service or a stand-alone system module
- Subcomponents such as code segments, rule bases, configurations, customizations, and other parts of a system or module that are designed for reuse
How do states get started with reuse?
To get started with reuse, a state can:
- Review the state Medicaid director letter (SMD #18-005) on reuse (PDF, 70.77 KB)
- View the introductory video to get familiar with the concept and framework of reuse
- Contact the Medicaid Enterprise Systems (MES) at MES@cms.hhs.gov to request access to the MES Reuse Repository
What is the Reuse Repository, and how can states access it?
The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Enterprise Systems (MES) Reuse Repository to support states’ ability to share and reuse project life cycle artifacts. The repository is available on the CMS zONE (Opportunity to Network and Engage). States must have a CMS Enterprise Identity Management login to access the Reuse Repository.
View complete instructions for accessing the Reuse Repository.
Contact MES at MES@cms.hhs.gov for additional assistance in accessing the repository.
Is training available for reuse concepts and tools?
The reuse webpage on Medicaid.gov features an introductory video and more information about reuse. The webpage also has policy guidance documents.
The Medicaid Enterprise Systems Reuse Repository has instructions on how to use its features. These include how to add artifacts, search for artifacts, use the discussion forum features, and more.
How do states share?
States can share reusable artifacts with others in several ways. States can participate in workgroups such as the Medicaid Management Information System Cohort, State Technical Advisory Group, and any other relevant state groups to facilitate knowledge sharing, partnerships, and collaboration. States with access to the Reuse Repository also may add their reusable artifacts directly to the repository.
View complete instructions for accessing the Medicaid Enterprise Systems (MES) Reuse Repository. Contact MES at MES@cms.hhs.gov for additional assistance in accessing the repository or participating in workgroups.
If a state is reusing a system or module already certified in another state, do they still need to go through certification review and decision?
Certification is required for any new implementation, whether it is a custom- developed module that is transferred from another state, or a commercial off-the-shelf module that is being configured and integrated. The certification process looks at the state’s implementation of the solution to ensure the state has met all federal requirements.
States may reuse system documentation and other supporting evidence from a previous state certification if it is available and applicable to their systems and has been reconfirmed by independent verification and validation.