NCQA proposes accrediting LTSS coordinators

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Entities that coordinate long-term services and supports could be evaluated and accredited by the National Committee for Quality Assurance under a new initiative announced by the group. The NCQA is welcoming comments on its proposal through March 23.

Proposed standards developed by the not-for-profit organization have the goal of improving care for those who need LTSS by requiring LTSS coordinators to:

  • Institute person-centered care planning.
  • Manage care transitions.
  • Use a critical incident management system to report, track and follow up on incidents such as abuse, neglect and exploitation.
  • Coordinate care and services for those who have complex needs and multiple providers.
  • Set and verify qualifications, and give training and support, to providers of home- and community-based services.  

The NCQA says that its staff members spent months consulting with LTSS providers, consumer advocates, payers and policy experts to draft the standards. They apply to two existing accreditation products — Health Plan Accreditation (HPA 2017) and Managed Behavioral Healthcare Organization Accreditation (MBHO 2017) — and would become effective in July 2017. The NCQA also has drafted additional standards for a new product, Case Management for Individuals Receiving LTSS (CM-LTSS). Those standards would become effective upon their release this July.

The NCQA is in the process of determining the entities that would be eligible for the program. Among the entities being considered are community-based organizations such as area agencies on aging, centers for independent living, and aging and disability resource centers; managed LTSS health plans that are only responsible for the provision of LTSS and do not coordinate medical/behavioral health benefits; and case management organizations that coordinate LTSS.

Those who wish to read the proposed changes or comment on them must log in to the NCQA website or create an account.

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