CMS Reporting to the Healthcare Integrity and Protection Data Bank

WHY WE DID THIS STUDY

In a 2010 report entitled(OEI 07 09 00290), OIG found that CMS took adverse actions against providers but did not report all of these actions to the Healthcare Integrity and Protection Data Bank (HIPDB) as required. For example, none of the adverse actions against durable medical equipment (DME) suppliers taken during 2008 had been reported to the HIPDB as of April 30, 2009. In the 2010 report, OIG recommended-and CMS concurred-that CMS should report all adverse actions as required. This memorandum report provides an assessment of CMS's reporting to the HIPDB approximately 2 years after the release of the initial report.

HOW WE DID THIS STUDY

We obtained a copy of the data in the HIPDB as of April 1, 2012. We compared these HIPDB data (e.g., the number, frequency, and types of adverse actions reported by CMS) with the data obtained for our 2010 report. By comparing the data from April 1, 2012, with those from April 30, 2009, we were able to make conclusions about the extent to which CMS's reporting to the HIPDB addresses our 2010 report recommendation.

WHAT WE FOUND

CMS improved its reporting of adverse actions for DME suppliers, but not for other types of providers. CMS has not fully addressed our 2010 report recommendation to report required adverse actions to the HIPDB or to report such actions within required timeframes.

WHAT WE CONCLUDE

Based on the results of our review, our 2010 recommendation that CMS should report all adverse actions as required remains open.