OIG issues rule on ‘integrity’ bank
December 1, 1999 2 minutes read
OIG issues rule on integrity’ bank
Here’s what would be included
The Office of Inspector General (OIG) has published its final rule implementing the Healthcare Integrity and Protection Data Bank (HIPDB). It is a compliment to the existing National Practitioner Data Bank, which tracks medical malpractice payments, adverse licensing actions, adverse clinical privileges actions, and disciplinary actions taken against physicians, dentists, and other health care providers by professional membership societies.
The Health Insurance Portability and Account ability Act (HIPAA) of 1996 required the Depart ment of Health and Human Services (HHS) to establish a national health care fraud and abuse data collection program for the reporting and disclosing of actions taken against health care provi ders, suppliers, and practitioners.
The HIPDB will contain the following information:
• civil judgments against a health care provi der, supplier, or practitioner in federal or state court related to the delivery of a health care item or service;
• federal or state criminal convictions against a health care provider, supplier, or practitioner related to the delivery of a health care item or service;
• actions by federal or state agencies responsible for the licensing and certification of health care providers, suppliers, or practitioners;
• exclusion of a health care provider, supplier, or practitioner from participation in federal or state health care programs;
• any other adjudicated actions or decisions that HHS establishes by regulation.
By law, the following entities must report to, and are the only groups authorized to receive information from, the data bank:
• state and federal law enforcement organizations;
• state and federal agencies responsible for licensing or certifying a health care practitioner, provider, or supplier;
• federal agencies that administer or provide payment for health care;
• private health plans.
The charge for information searches requested are still being finalized. However, the OIG estimates initial fees should be about $4 per query from nonfederal sources and $10 per request for individual practitioners, providers, and suppliers asking to examine their own files.
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