CMS Issues Guidance For Medicaid External Quality Review For Long-Term Services & Supports

On October 15, 2013, the federal Centers for Medicare & Medicaid Services (CMS) said that moving Medicaid long-term services and supports (LTSS) to managed care will require external quality review organizations (EQROs) to revise protocols from the current medical orientation to adapt to non-medical LTSS. A key change will be identifying sources of information that document compliance with Medicaid managed care regulations, and that validate performance measures reported by Medicaid managed care organizations (MCOs). There are eight quality review protocols; three are mandatory parts of quality review activity, and five are voluntary. CMS released guidance on how to . . .