Case Study
The Practice
Quality Assurance & IVV
The Client
Large New York State agency with operations throughout the state.
The Challenge
The Home and Community-Based Services (HCBS) Final Rule regulations set forth new requirements for several Medicaid authorities under which states may provide home and community-based long-term services and support. The regulations enhance the quality of HCBS and provide additional protections to individuals that receive services under these Medicaid authorities.
The Solution
Garnet River analyst team, with knowledge in HCBS Final Rule, Person-Centered Practices (PCP) and Medicaid, works with the Department of Health to review and evaluate documentation against applicable state/federal regulations. The team then conducts statewide reviews to ensure CMS compliance with Social Adult Day Care, provides guidance to providers on the guidelines, assists with all internal and external reporting relating to the reviews, and builds and maintains relationships with stakeholders to provide high-level customer service.
Managed long-term care (MLTC) is a system that streamlines the delivery of long-term services to people who are chronically ill or disabled and wish to stay in their homes and communities. These services, such as home care or Social Adult Day Care (SADC), are provided through MLTCs that are approved by the State
The Impact
Our client capability ensures support is given to the MLTCs and the SADCs to become and remain compliant with the guidelines set forth by CMS, enhancing the lives of the members receiving these services.
