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Proposed critical incident management system survey open for comment

The U.S. Centers for Medicare & Medicaid Services (CMS) is preparing to survey state Medicaid agencies on their critical incident management practices … again. A similar survey of critical incident management systems (CIMS) was completed in July 2019 by administrators of state 1915(c) Medicaid waiver programs. The information gathered helped inform the federal agency about how states are approaching incident management across the country.

This newest version is designed to be shorter and more targeted, for the purpose of identifying best practices for incident management, training and prevention. Additionally, CMS will use survey data to evaluate state progress in improving incident management practices over the last four years.

Protecting the vulnerable

Medicaid 1915(c) waiver program participants receive home- and community-based services (HCBS), so they can live at home, rather than in institutional settings. While home and community living provides many benefits for aging and disabled populations, inherent risks for abuse and neglect can come with a lack of institutional oversight.

For individuals living at home, unreported and unresolved incidents of abuse put already vulnerable populations at further risk for injury, illness or even death. State Medicaid agencies that administer HCBS programs need to be equipped to identify potential instances of abuse, neglect and exploitation, and they must have systems in place to aid in the timely investigation and resolution of reported events.

Based on the 2019 CIMS survey data, CMS has written critical incident management system requirements into one of its latest proposed rules. According to that rule, state agencies must have the ability to electronically:

  • submit incident reports from a variety of entities, including Medicaid fraud control units, adult protective services, child protective services and law enforcement.
  • track incident investigation status.
  • share data with other incident reporting entities to aid in investigations.

Comments welcome

Comments on the proposed 2024 CIMS survey can be submitted to CMS until Dec. 4. As it stands now, the survey includes 10 sections:

  • General overview
  • System questions
  • Reporting
  • Incident resolution
  • Quality improvement
  • Collaboration with other state agencies
  • Training
  • Prevention
  • Mitigation of fraud, waste and abuse

State Medicaid agencies administering 1915(c) Medicaid waiver programs will be asked to fill out a survey for each program that has a unique incident management system. Some states have one solution for multiple programs, while others have one system for each unique waiver. The survey should take administrators between 60 and 90 minutes to complete, according to CMS.

“State responses will be used for purposes of identifying promising practices and developing technical assistance tools such as webinars and learning collaboratives,” according to CMS. “Individual state information from this survey will not be disclosed publicly.”

At FEI Systems, we applaud the ongoing prioritization of incident management by CMS, and we are proud to support our partners in this mission critical work. We’ve built our comprehensive incident management solution to meet the needs of our state partners and the populations they serve. Our configurable, online system helps state Medicaid agencies classify incident types, quickly route reported events for investigation and follow up and report on incident management activity.