ProPublica’s Marian Wang reports that the Centers for Medicare & Medicaid Services “essentially undermined” HHS efforts to create a national database of disciplined health care providers by failing to report disciplinary actions. The news comes from a report by the HHS Office of Inspector General (23-page PDF).
According to Wang, the investigation “found that CMS, which oversees health care programs serving about 45 million Medicare beneficiaries and 59 million Medicaid beneficiaries, took disciplinary action against numerous bad medical providers but did not report those actions to the Healthcare Integrity and Protection Data Bank.” As anyone who’s been following ProPublica’s award-winning “When Caregivers Harm” series knows, the database is chronically deficient, and – despite federal requirements – CMS isn’t helping.
CMS is required by law to report the following types of disciplinary action to the database: revocations and suspensions of laboratory certifications; terminations of providers from participation in Medicare; civil monetary penalties against all types of providers, managed care plans, and prescription drug plans.
Some of the data that should’ve been reported includes 148 sanctions imposed against laboratories in 2007 and 30 sanctions taken against managed care and prescription drug plans between January 2006 and July 31, 2009. From 2004 to 2008, the agency banned 45 nursing homes from participating in Medicare, and those actions were not reported until fall 2009, long after the required reporting timeframe, the inspector general’s office said.
According to officials, it was all just a big misunderstanding.
