Addressing Critical Incidents in the MLTSS Environment: Research Brief. Introduction


As states move their Medicaid populations with disabilities from fee-for-service arrangements into managed long-term services and supports (MLTSS) environments, there is interest in ensuring that member health and welfare is safeguarded in this environment. The Centers for Medicare and Medicaid Services' (CMS's) guidance on the design of Medicaid MLTSS programs1 includes a focus on member protections and the importance of having a critical incident reporting and management system. These systems are designed to respond to incidents that place a member at risk of harm. This Brief discusses the ways in which some established MLTSS programs manage critical incidents.2 In all of these programs, the managed care organization (MCO) plays a key role in a state's MLTSS critical incident system.

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"CritIncidRB.pdf" (pdf, 79.42Kb)

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