ODM Proposed Changes to Incident Management Rules

The Ohio Council recently submitted comments to the Ohio Department of Medicaid on a package of proposed updates to incident management rules including OAC 5160-44-05, 5160-26-14, and 5160-59-09. Together, these rules govern incident reporting, investigation, and follow-up responsibilities for Medicaid providers, managed care organizations, and OhioRISE care management entities. The proposed changes make needed clarifications across various Medicaid programs and create more consistency while meeting discrete federal requirements embedded in specific waivers or programs.

In our comments, we focused on implementation considerations, including clarity around incident notification requirements, appropriate involvement of providers following incident investigations, and the administrative burden created by overlapping reporting and oversight processes. We encouraged ODM to consider opportunities to align requirements across systems and reduce unnecessary duplication while maintaining appropriate safeguards for individuals served.

The Ohio Council will continue to monitor developments on this rule package and share updates with members.