This document provides information on modifications to the quality assurance systems needed to meet the assurances for §1915(c) waivers. These changes strengthen the oversight of beneficiary health and welfare and realign the reporting requirements. The highlights of this modified quality assurance system include:

1. Health and welfare monitoring and outcomes are emphasized;

2. Although states must continue to remediate issues, the reporting on individual remediation to CMS will not be required except in substantiated instances of abuse, neglect or exploitation; and

3. States’ quality improvement projects/remediation will be required when the threshold of compliance with a measure is at or below 85%

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Changes in Quality Measures for Waivers