Quality Assurance

The State of Nevada, Division of Health Care Financing and Policy (DHCFP), Quality Assurance (QA) Team is responsible to ensure that the 1915(c) Home and Community Based Services (HCBS) Waivers and Personal Care Services (PCS) Programs effectively meet our recipients' needs and are implemented in accordance with Medicaid statute and regulations, program policies, federal statutory assurances, waiver requirements, Nevada Revised Statutes (NRS), Nevada Administrative Code (NAC) and the Code of Federal Regulations (CFR).

The Centers for Medicare and Medicaid Services (CMS) expects states to follow a continuous quality improvement (CQI) process in the operation of each program. The process involves a continuous monitoring of the implementation of each program, methods for remediation or addressing identified individual problems and areas of noncompliance, and processes for a) aggregating collected information on discovery and remediation activities, and b) prioritizing and addressing needed systems changes on a regular basis. Through an ongoing process of discovery, remediation, and improvement, the State assures the health, safety and welfare of the recipients by monitoring (a) level of care determinations; (b) recipient's plans and services delivery; (c) provider qualifications; (d) recipient health safety and welfare; (e) financial oversight and (f) administrative oversight regarding the quality management (QM) of the programs.

    Medicaid Service Manuals

    Home and Community Based Services (HCBS) Waivers

    MCQA General Guidance Letters

    Home and Community Based Services (HCBS) State Plans