FAQ Directory: Long-Term Services and Supports Distinction for Health Plans

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2.15.2023 Use of software for evidence-based clinical guidelines for PHM 5, Element B For PHM 5, Element B, factor 1, is it considered delegation if an organization uses evidenced-based clinical content licensed for use in their own case management system?

No. The use of another entity’s evidence-based content within the organization’s case management system is not considered delegation if the organization maintains control over how the content is used and can customize it as needed. The evidence used to support the content must be cited.

HP 2023