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FAQ Directory: Long-Term Services and Supports Distinction for Health Plans

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8.24.2018 What organizations are eligible for the LTSS Distinction for Health Plans? What organizations are eligible?

An organization is eligible for the NCQA LTSS Distinction for a product/product line if:

  • The product/product line has a current NCQA Accreditation status, or
  • The product/product line is seeking NCQA Health Plan Accreditation.

Note:  NCQA conducts LTSS Distinction Surveys at the legal-entity level. Organizations undergoing Interim Survey are not eligible for LTSS distinction.

Health plans that coordinate LTSS and do not provide medical or behavioral services are not eligible for this distinction but can earn Accreditation of Case Management for LTSS.
 

HP 2020

8.24.2018 Where can I find information to help me get started with the Medicaid Module?

8.24.2018 What other health plans have earned LTSS Distinction?

8.24.2018 How long does it take to earn LTSS Distinction for Health Plans?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

HP 2020

8.24.2018 Where can I find information to help me get started with Health Plan Accreditation?

8.24.2018 Where can I find the LTSS Distinction Standards and Guidelines?

8.24.2018 What is Health Plan Accreditation?

NCQA Health Plan Accreditation is the most widely recognized, evidence-based program in the industry dedicated to quality improvement and measurement. It provides a comprehensive framework for organizations to align and improve operations in areas that are most important to states, employers and consumers. It’s the only evaluation program that bases results on actual measurement of clinical performance (i.e., HEDIS measures) and consumer experience (i.e., CAHPS measures).

HP 2020

8.24.2018 What is the process for earning LTSS Distinction for Health Plans?

The first step to earning distinction is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.

Align your organization’s processes with the standards. NCQA conducts the survey and determines your distinction status within 30 days of the final review.

See a step-by-step process.

HP 2020

8.24.2018 Where can I find the Medicaid Module Standards and Guidelines? How can I obtain the Medicaid Module Standards and Guidelines?

8.24.2018 What is Long-term Services and Supports Distinction for Health Plans?

NCQA LTSS Distinction for Health Plans is a complementary program designed to support health plans coordinating LTSS. The program standards provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state requirements.

HP 2020

8.24.2018 What are Health Plan Accreditation requirements?

NCQA standards are a roadmap for improvement—organizations use them to perform a gap analysis and align improvement activities with areas that are most important to states and employers, such as network adequacy and consumer protection. Standards help plans in:

  • Quality Management and Improvement.
  • Population Health Management.
  • Network Management.
  • Utilization Management.
  • Credentialing and Recredentialing.
  • Members’ Rights and Responsibilities.
  • Member Connections.
  • Medicaid Benefits and Services.

HP 2020

8.24.2018 Where can I find the Health Plan Accreditation Standards and Guidelines?