Yes. Employees and their dependents are excluded from the CCM file review universe.
CM 2019
Yes. Assessment and evaluation each require a case manager or a qualified individual to draw and document a conclusion about the data or information collected. Raw data or answers to questions do not meet the requirement; there must be a documented summary of the meaning or implications to the member’s situation, so data can be used in the case management plan.
The organization must draw a conclusion for each factor (unless otherwise stated in the explanation). This may be in separate summaries for each factor or in a combined summary, or in a combination of these.
CM 2019
No. After consideration, NCQA removed the requirement for case managers to address life-planning activities at the start of the initial assessment (first contact). This FAQ replaces the previous FAQ issued on October 15, 2017 (which has been deleted) regarding first contact, and the workbook has been adjusted to accommodate the change.
CM 2019
Yes. For non-file review requirements, if the arrangement was terminated more than 90 calendar days before submission of the completed survey tool, the organization is eligible for automatic credit for the portion of the look-back period when the NCQA-Accredited/ Certified/Recognized delegate conducted activities. For file review requirements, automatic credit is applied if the delegate processed (or handled) the file, regardless of when the delegation arrangement was terminated.
CM 2017
Organizations that have earned NCQA LTSS Distinction can be found in the NCQA Report Card.
CM 2017
An organization is eligible for the NCQA LTSS Distinction if:
Note: NCQA conducts LTSS Distinction Surveys at the legal-entity level.
CM 2017
Find the Standards and Guidelines document in the NCQA eStore.
CM 2017
If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.
CM 2017
CM 2017
Earning NCQA Accreditation of Case Management for LTSS can help organizations:
CM 2017