Reminder: Adverse Incident Reporting Resources

Date: 03/05/21

As a reminder, adverse incidents (AI) are investigated and tracked in an effort to develop and implement systems to promote the health, safety and welfare of individuals receiving behavioral health services. In 2018, LDH began requiring providers to use an the updated AI form to report adverse incidents to Louisiana’s Medicaid Managed Care Organizations.

The updated AI Reporting Form and AI Reporting Form Instructions can be found on the Louisiana Healthcare Connections website:

REMINDER: As mandated reporters, and as required by Louisiana’s Children’s Code Title VI, Article 603, and LDH, healthcare providers are required to submit the AI Reporting Form within ONE business day of discovery of the adverse incident to the affected member’s Healthy Louisiana health plan.

LDH has provided the following example to clarify the “within one business day” reporting requirement: For example, if the time of discovery of the incident is on Friday at 4 p.m., and the reporting provider’s office closes at 5 p.m., the provider will have until the following Monday at 4 p.m. to report the incident to the appropriate Healthy Louisiana health plan.

For Louisiana Healthcare Connections members, the AI Reporting Form must be submitted via fax to 1-866-704-3063 or to the QOC secure email at QOC@louisianahealthconnect.com.

NOTE: If the incident is reportable to a protective agency, such as DCFS, APS, or LDH, there must be documentation included in Section 4 of the AI Reporting Form that those agencies were informed immediately.

Providers are encouraged to use the following Frequently Asked Questions to educate their staffs about AI reporting requirements:

What is an adverse incident?

An adverse incident is defined as an unexpected occurrence that led to, or could have led to, serious unintended or unexpected harm, loss, or damage. Adverse incidents result in unintended harm to the patient by an act of commission or omission, rather than by the underlying disease or condition. These include death, abuse, neglect, extortion, and/or exploritation.

Is the AI Reporting Form different for each Healthy Louisiana plan?

No. All of the Healthy Louisiana health plans, including Louisiana Healthcare Connections, use the same AI Reporting Form. Louisiana Healthcare Connections tracks and monitors providers to ensure compliance with the state’s adverse incident reporting requirements.This form must be submitted to the affected member’s health plan, not the state.

Where can providers get adverse incident training?

Louisiana Healthcare Connections provides regular Adverse Incident Reporting Training at no cost to providers. Providers can register for this training (and other free educational and training opportunities) by visiting https://www.louisianahealthconnect.com/providers/resources/provider-training.html.

TIP: When submitting an AI Reporting Form, please verify that you are utilizing the correct, current form. The updated AI Reporting Form indicates the version date of October 16, 2018, in the lower right corner.