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… results in Automated Decision Making.
- September 10, 2015
Ensuring that Assessment Tools are Available to Enrollees
Read moreThe amount of Medicaid services for enrollees, particularly home and community based services, is increasingly being determined through prior authorization processes that use assessment tools and clinical coverage criteria. These assessment documents may not be made available to the enrollee. However, Medicaid law and due process call for disclosure…
- May 5, 2015
Medicaid Assessments for Long-Term Supports & Services (LTSS)
Read moreLong-term care needs assessments serve a vital role in Medicaid. For individuals with disabilities and older adults, needs assessments are used to determine eligibility for both institutional and home and community-based services (HCBS). The assessment process establishes the type and extent of an individual's care needs, which inform the…