Au­dit: CMS isn’t re­port­ing vi­o­la­tions con­sis­tently

Modern Healthcare - - LATE NEWS -

The CMS has done bet­ter re­cently in re­port­ing vi­o­la­tions by durable med­i­cal equip­ment sup­pli­ers to a na­tional data­base used to keep fraud­sters out of the health­care sys­tem, but an au­dit said the agency is still not meet­ing other re­port­ing re­quire­ments. HHS’ in­spec­tor gen­eral’s of­fice said in a four­page fol­low-up au­dit that the CMS has not been con­sis­tently re­port­ing prob­lems with nurs­ing homes, lab­o­ra­to­ries, man­aged-care plans and pre­scrip­tion-drug plans to the Health­care In­tegrity and Pro­tec­tion Data Bank. The CMS im­posed 148 “ad­verse events,” such as ex­clu­sion from Medi­care and crim­i­nal con­vic­tions against lab­o­ra­to­ries in 2007, and 30 such events against man­aged-care and drug plans be­tween 2006 and 2009— but none of those events was in­cluded in the data­bank as of April 1, the au­dit found. The CMS also ap­peared to be re­port­ing vi­o­la­tions by nurs­ing homes only on an an­nual ba­sis, even though those re­ports are sup­posed to be made monthly. The agency has fol­lowed the rec­om­men­da­tion from a 2010 au­dit to in­clude and reg­u­larly up­date thou­sands of ad­verse events taken against sup­pli­ers of durable med­i­cal equip­ment, the au­di­tors said. The data­base, which is used by health­care providers to make sure they are not em­ploy­ing or con­tract­ing with pro­hib­ited peo­ple and or­ga­ni­za­tions, is in the process of be­ing merged with the Na­tional Prac­ti­tioner Data Bank be­cause of a con­sol­i­da­tion re­quire­ment in the Pa­tient Pro­tec­tion and Af­ford­able Care Act.

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