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Managed Long Term Services & Supports FAQs

The Centers for Medicare & Medicaid Services (CMS) has contracted with Mathematica Policy Research1 and its partner, the National Committee for Quality Assurance, to develop measures for people receiving long term services and supports through managed care organizations and prepaid inpatient health plans. These measures provide information about assessment and care planning processes with Managed Long Term Services and Supports (MLTSS) plan members, as well as Long Term Services and Supports use and rebalancing, that can be used by states, managed care plans, and other stakeholders for quality improvement purposes.

These frequently asked questions provide additional information and address common questions about these measures. View a printer-friendly version of these frequently asked questions.

1Measures developed as part of CMS contract: Quality Measure Development and Maintenance for CMS Programs Serving Medicare-Medicaid Enrollees and Medicaid-Only Enrollees, HHSM-500-2013-13011I, Task Order #HHSM- 500-T0004.

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Should the rate of required exclusions be reported with the Screening, Risk Assessment, and Plan of Care to Prevent Future Falls measure's Part 1 performance rate?

The measure excludes plan members who are not ambulatory from the measure rate, but it is not necessary to report the number of members excluded with the measure’s performance rate.

FAQ ID:89006
Is a specific screening tool required for the Screening, Risk Assessment, and Plan of Care to Prevent Future Falls measure?

No, a specific screening tool is not required for this measure. However, potential screening tools may include the Morse Fall Scale and timed Get-Up-And-Go test.

FAQ ID:89011
What is the difference between a screening (Part 1) and a risk assessment (Part 2) for the purposes of calculating the Screening, Risk Assessment, and Plan of Care to Prevent Future Falls measure?

A falls screening is an evaluation of whether a Managed Long Term Services and Supports plan member has experienced a history of falls and/or problems with balance or gait. A falls risk assessment includes a balance/gait assessment and one other assessment component and should only be performed for members with a documented history of falls (at least two falls or one fall with injury in the past year).

FAQ ID:89016
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