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Why does the LTSS Reassessment/Care Plan Update after Inpatient Discharge measure exclude members who do

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
FAQ ID
89246
FAQ Question
Why does the LTSS Reassessment/Care Plan Update after Inpatient Discharge measure exclude members who do not receive medical benefits through their Managed Long Term Services and Supports (MLTSS) plan?