Accreditation of Case Management for Long-Term Services and Supports FAQs

What is Accreditation of Case Management for LTSS?

NCQA Accreditation of Case Management for LTSS is a comprehensive, program designed to support health plans that focus on coordinating LTSS. The program standards provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state requirements.

How does this Accreditation help my organization?

Earning NCQA Accreditation of Case Management for LTSS can help organizations:

• Become more efficient. A focus on coordinated care, training and measurement can help organizations reduce errors and duplicated services.
• Integrate care better. Standards can help organizations improve communication between individuals, caregivers, providers, payers and other organizations that coordinate care.
• Provide person-centered care. Standards focus on person-centered services, which can lead to better care planning and monitoring.
• Support contracting needs. Standards align with the state needs. NCQA-Accredited organizations demonstrate that they’re ready to be trusted partners in coordinating LTSS services.

Where can I find the Standards and Guidelines?

Find the Standards and Guidelines document in the NCQA Store.

What organizations are eligible?

Health plans that coordinate LTSS and do not provide medical/behavioral health are eligible for this accreditation.

NCQA-Accredited MBHOs or health plans that offer comprehensive medical benefits and manage LTSS are not eligible for this accreditation but can earn LTSS Distinction.

What is the process for earning Accreditation?

The first step to earning accreditation is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.

Align your organization’s processes with the standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review.

See a step-by-step process.

What is the price for this Accreditation?

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

How long does it take to earn Accreditation?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

How do I get started?

If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.

Where can I find information to help me get started?

• Accreditation Process and Timeline: Key steps, timing and resources for a successful accreditation.
• Standards and Guidelines: The complete standards and guidelines, including the intent and scope of review.
• Interactive Survey Tool: Contains the complete standards and guidelines; you can also determine your organization’s survey readiness—the tool calculates your potential survey score.

Are there additional resources?

• LTSS Best Practices Academy: Interactive forum for professionals to discuss strategies for coordinating quality long-term services and supports (LTSS) programs.
• LTSS Roadmap: A compilation of resources to guide organizations through meeting Case Management and Health Plan Standards for LTSS.

What other organizations have earned Case Management Accreditation?

Organizations that have earned NCQA Accreditation of Case Management for LTSS can be found in the NCQA Report Card.