Case Study
The Practice
Quality Assurance & IVV
The Client
A state agency
The Challenge
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 homecare or Social Adult Day Cares (SADC), are provided through MLTCs that are approved by the state’s Department of Health.
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’s analyst team, with knowledge in HCBS Final Rule, Person-Centered Practices (PCP), and Medicaid, works with the state agency 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, provide guidance to providers on the guidelines, assist with all internal and external reporting relating to the reviews, and build and maintain relationships with stakeholders to provide high-level customer service.
The Impact
Our client 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.
