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

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5.15.2017 QI 5 Element G: Complex Case Management Assessment and Evaluation Is collecting information or data only for each factor sufficient to meet the “assessment” or “evaluation” requirements in QI 5, Element G (QI 9, Element G in MBHO)?

No. Presenting data alone is not sufficient. The case manager must draw a conclusion from the data and note it in the member’s file.

Note: Effective for complex case management files that were opened on or after September 1, 2017.

HP 2017