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Federal Centers for Medicare and Medicaid Services (CMS) Clears Maine DHHS of All Findings Related to 2017 Audit of Home and Community Based Services (HCBS) Programs for Adults with Intellectual and Developmental Disabilities?Federal Office of Inspector General (OIG) Finds Maine in Compliance

On June 6, 2022 the U.S. Department of Health and Human Services, Office of Inspector General (OIG) released its final report Maine Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents. The report was a follow up to an earlier report issued in 2017, in which the OIG found that Maine group home providers for adults with intellectual disabilities did not report all serious incidents to the Department and did not review and follow up on incidents within 30 days.? The 2017 report also found that the Department did not review and analyze the incidents submitted by providers and did not consistently refer serious cases of abuse, neglect or exploitation to law enforcement.?

In its follow up audit, the OIG now finds that ?Maine implemented the seven recommendations from our prior audit and generally complied with Federal and State requirements for reporting and monitoring critical incidents involving Medicaid beneficiaries with developmental disabilities.?? This follows confirmation from CMS on May 3, 2022 that CMS has now closed all findings from the prior audit.?

In response to the 2017 audit, the Department took several actions, including:

  • Implemented an electronic reporting system for providers to submit all reportable events;
  • Trained providers on what constitutes a reportable event, and how to report and follow up on events;
  • Referred all incidents involving serious allegations to law enforcement;
  • Supported creation of a Home and Community Based Services Mortality Review Panel at Maine CDC to review all deaths of HCBS participants, analyze trends, and identify systemic issues;
  • Assigned eight district staff to dedicated quality assurance roles. These staff monitor reportable events and other quality information, conduct quarterly meetings with agencies to review events and data trends, provide technical assistance?as needed,?assess referrals from adult protective regarding service quality, assure all mandatory reporting has been completed, and coordinate with other oversight entities.

The Department is committed to continuous quality oversight to ensure the health, welfare, and protection of individuals with intellectual and developmental disabilities in Maine. The Department appreciates the continued collaborative efforts of self-advocates, family members, advocates, community-based providers, and our federal partners at OIG and CMS in achieving compliance with these important safeguards and sustaining them going forward.

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