Saturday, September 15, 2012

CMS Fails To Report To Anti Fraud Database, OIG Says

Fierce Healthcare has;
CMS Fails To Report To Anti-Fraud Database, OIG Says
September 14, 2012 | By Alicia Caramenico

The Centers for Medicare & Medicaid Services still isn't living up to healthcare fraud reporting requirements, failing to report all disciplinary actions against providers to the national Healthcare Integrity and Protection Data Bank, the Office of the Inspector General said in a report released Wednesday.

The report follows up on recommendations given to CMS in 2010 to improve reporting adverse actions imposed against nursing facilities, laboratories and durable medical equipment suppliers.

One bright spot in the follow-up is that CMS has improved its reporting of adverse actions for DME suppliers. However, the OIG found that the HIPDB contains no reports of nursing home terminations since June 2010, suggesting CMS has not been reporting them to the anti-fraud database.

Moreover, the HIPDB still doesn't contain reports of CMS-imposed adverse actions for laboratories, managed care plans and prescription drug plans, among other providers.

The OIG made no new recommendations for CMS, but said its 2010 recommendation to report all adverse actions as required by law still stands.

Earlier this summer, OIG was at odds with the U.S. Health & Human Services Department, saying it failed to provide complete quarterly reports in 2010 and therefore can't adequately assess how vulnerable its programs are. HHS "respectfully disagreed" with the findings.

For more:
- read the OIG 
summary and report (.pdf)

Thank You Fierce Healthcare and Ms Caramenico

No need to be unduly concerned Citizens. We have Top people working on the problem, ..... Top people.

"To date, the $77 million computer system, which went online in mid-2011, had prevented exactly one bad claim by late last year. That totaled $7,591."

Top, people. 

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