Innovations Back-Up Staffing Report Form

According to the Joint Communication Bulletin, it is the expectation that if a provider or Employer of Record (EOR) staff member is unable to provide a service and the provider agency or EOR is unable to provide back-up staff, the provider or EOR is required to report this lack of staffing to the LME-MCO. This should be sent by the provider agency to the LME-MCO on a bi-weekly basis. Please use the bi-weekly fillable PDF (Innovations Incident Report for Failure to Provide Back-Up Staffing) to report this lack of staffing. Effective 1/1/18, back-up staffing reports in other formats will no longer be accepted and will be returned to the provider agency for resubmission on the correct form. For questions, please contact Diane Sofia at [email protected].

Page last modified: December 8, 2017