Pennsylvania Implemented Our Prior Audit Recommendations for Critical Incidents Involving Medicaid Enrollees With Developmental Disabilities but Should Continue To Take Action To Reduce Unreported Incidents

We recommend that the Pennsylvania Department of Human Services expand the pilot program to other regions to periodically match Medicaid claims with diagnosis codes indicating potential abuse or neglect to 24-hour reportable incidents recorded in the incident reporting system.

We recommend that the Pennsylvania Department of Human Services continue working with supports coordinators to ensure they verify with the community-based provider that incidents that they are aware of are reported in the EIM system.