CMS has not consistently reported problems with laboratories, managed care plans, nursing homes and prescription drug plans to the Healthcare Integrity and Protection Data Bank, according to an audit by HHS' Office of Inspector General, Modern Healthcare reports (Carlson, Modern Healthcare, 9/13).
Details of the Database
HIPDB aims to help hospitals and other organizations hire health care providers who are in good legal standing with health care regulations, as well as Medicare and Medicaid program requirements.
Federal law requires CMS to update the database with information on:
- Civil monetary penalties levied against health care providers, managed care plans and prescription drug plans;
- Terminations of participation in Medicare; and
- Revocations and suspensions of laboratory certifications.
In 2010, OIG issued a report finding that CMS had failed to report certain disciplinary actions against health care providers to HIPDB. The report recommended that CMS quickly begin reporting such actions to HIPDB and "educate staff and contractors about the types of adverse actions to be reported and the time frames for reporting" (iHealthBeat, 9/23/10).
Audit Findings
The latest audit found that CMS has complied with OIG's 2010 recommendation to regularly update HIPDB with information about disciplinary actions taken against vendors of durable medical equipment.
However, it also found that as of April 1, the database did not include information on 148 disciplinary actions taken against laboratories in 2007 and 30 actions taken against managed care and prescription drug plans between 2006 and 2009.
In addition, the audit found that CMS is reporting nursing home violations on an annual basis even though it is required to report such violations on a monthly basis (Modern Healthcare, 9/13).