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
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).
No, discharges that result in readmission to the institution within 60 days of discharge from the institution do not meet the LTSS Minimizing Institutional Length of Stay and LTSS Successful Transition after Long-Term Institutional Stay measure numerator criteria.
Do not count the day of discharge unless the member’s admission and discharge occurred on the same day. If the admission and discharge occurred on the same day, the number of days in the stay is equal to one.
If there is no discharge, calculate the length of stay as the date of the last day of the measurement year minus the institutional facility admission date.
Yes, the LTSS Minimizing Institutional Length of Stay and LTSS Successful Transition after Long- Term Institutional Stay measures are risk-adjusted based on the members’ dual eligibility status, age and gender, diagnoses from the institutional facility admission, and number of hospital stays and months of enrollment in the classification period. See the risk adjustment weights needed for these measures are in the risk adjustment tables.
No, do not include these admissions in the LTSS Successful Transition after Long-Term Institutional Stay measure denominator.
No, these would be two distinct institutional stays; do not remove this admission from the Long Term Services and Supports Successful Transition after Long-Term Institutional Stay measure denominator.
If the member died in the institution or within one day of discharge from the institution, do not include their admission in the denominator. Members who died one day after discharge are excluded because of the high number of deaths the day after discharge observed while testing this measure; such members are unlikely to have been discharged alive. If the member died between day 2 and day 60 during the 60 days following discharge from the long-term institutional stay, do not include their discharge in the numerator.
The PERM/MEQC dates/cycles are as follows:
| PERM Cycle* | PERM Review Period | MEQC Planning Document Due to CMS | MEQC Review Period | MEQC Case-Level Report on Findings and CAP Due to CMS |
|---|---|---|---|---|
| Cycle 1 | July 1, 2017 – June 30, 2018 | November 1, 2018 | January 1 – December 1, 2019 | August 1, 2020 |
| Cycle 2 | July 1, 2018 – June 30, 2019 | November 1, 2019 | January 1 – December 1, 2020 | August 1, 2021 |
| Cycle 3 | July 1, 2019 – June 30, 2020 | November 1, 2020 | January 1 – December 1, 2021 | August 1, 2022 |
*??
CMS = Centers for Medicare & Medicaid Services
CAP = ??
As reconfigured under the final regulation of July 5, 2017, MEQC will work in conjunction with the Payment Error Rate Measurement (PERM) program. In those years when states undergo their triennial PERM reviews, the states will not conduct MEQC pilots. The latter will only be required in the two off-years between PERM review years. CMS has restructured the MEQC program so that it more effectively complements the PERM program and provides states with the necessary flexibility and opportunity to target specific problems or high-interest areas during the two off-years of the PERM cycle.