A NAMSS member recently contacted the blog, asking for help with a problem. The member submitted two reports manually, receiving a "Rejected" message for each report. This is the first time the member has received the messages and is wondering if other members are having the same issue, or can provide any insight as to what may solve the problem.
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Showing posts with label NPDB-HIPDB. Show all posts
Showing posts with label NPDB-HIPDB. Show all posts
Monday, July 11, 2011
Thursday, March 17, 2011
Report Highlights Inconsistency Between Hospital and State Licensing Actions Against Physicians
A March 2011 report by Public Citizen, a non-profit consumer advocacy group, found that out of the 5,887 physicians in the National Practitioner Data Bank (NPDB) "with one or more clinical privilege actions -- revocation or restriction of their clinical privileges," more than half had no state licensing actions taken against them. The report questions whether or not state medical boards are receiving reports of hospital actions and whether or not the medical boards are properly responding to reports of discipline through appropriate action at the state level.
Public Citizen examined clinical privilege reports, medical malpractice payment reports, as well as the NPDB Public Use File, which does not disclose the identity of the practitioners queried. It found that many physicians who had clinical privilege disciplinary actions related to incidents such as incompetence, sexual misconduct, fraud, malpractice, and being deemed "an immediate threat to health and safety" had reports in the NPDB, bit had no state licensure action taken against them.
The report issued several recommendations. First, it encouraged states to strengthen medical board oversight to improve performance in taking action against disciplined physicians. It also called on the boards to work with the Health Resources and Services Administration (HRSA) to ensure that action is taken against the physicians in the NPDB who curerntly have clinical privilege reports but no state licensure action. Finally, the report called on the Department of Health and Human Services Office of the Inspector General to resume investigations of state medical board effectiveness. This oversight review was last performed 18 years ago.
In response to the report, Humayun Chaudhry, D.O., president and CEO Federation of State Medical Boards (FSMB) stated:
To read the Public Citizen report, click here:
http://www.citizen.org/documents/1937.pdf
Sources: Public Citizen, FSMB
Public Citizen examined clinical privilege reports, medical malpractice payment reports, as well as the NPDB Public Use File, which does not disclose the identity of the practitioners queried. It found that many physicians who had clinical privilege disciplinary actions related to incidents such as incompetence, sexual misconduct, fraud, malpractice, and being deemed "an immediate threat to health and safety" had reports in the NPDB, bit had no state licensure action taken against them.
The report issued several recommendations. First, it encouraged states to strengthen medical board oversight to improve performance in taking action against disciplined physicians. It also called on the boards to work with the Health Resources and Services Administration (HRSA) to ensure that action is taken against the physicians in the NPDB who curerntly have clinical privilege reports but no state licensure action. Finally, the report called on the Department of Health and Human Services Office of the Inspector General to resume investigations of state medical board effectiveness. This oversight review was last performed 18 years ago.
In response to the report, Humayun Chaudhry, D.O., president and CEO Federation of State Medical Boards (FSMB) stated:
“While not every hospital action requires a medical license disciplinary action, many states have indicated that there is significant under-reporting to them of hospital sanctions. Recognizing this, several state medical boards and the Federation of State Medical Boards have been collaborating with HRSA since 2010 to explore ways of cross-referencing information contained in the National Practitioner Data Bank with the information the boards have in order to create a more effective reporting system. State medical and osteopathic boards do the best they can with the resources they have, but they cannot take an action against a physician if they are unaware of the problem. The report by Public Citizen is a reminder of the value of collaboration among many different groups (e.g., physicians, hospitals, state boards, federal agencies and the public) and the need for them to seek ways to work together in protecting the public and promoting quality health care.”
To read the Public Citizen report, click here:
http://www.citizen.org/documents/1937.pdf
Sources: Public Citizen, FSMB
Friday, February 18, 2011
HHS Proposes Rule Exempting Certain Law Enforcement Data from NPDB
The February 17, 2011 Federal Register includes a proposed rule issued by the Department of Health and Human Services (HHS) which would exempt law enforcement data connected to ongoing investigations from having to be reported to the National Practitioner Data Bank (NPDB).
The Privacy Act already exempts law enforcement information connected to ongoing investigations from having to be reported to the Healthcare Integrity and Protection Data Bank (HIPDB). Only law enforcement information connected to final adverse actions taken has to be reported.
The purpose of the rule is to prevent "[t]he premature disclosure of the existence of a law enforcement activity to an outside party(who may also be the subject of the investigation) could lead to, among other things, the destruction or alteration of evidence and the tampering with witnesses.”
HHS is accepting comments on the proposed rule through April 18, 2011. To see the proposed rule and instructions on how to submit comments, click here:
http://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=nnKHXl/0/2/0&WAISaction=retrieve
Sources: BNA, Federal Register
The Privacy Act already exempts law enforcement information connected to ongoing investigations from having to be reported to the Healthcare Integrity and Protection Data Bank (HIPDB). Only law enforcement information connected to final adverse actions taken has to be reported.
The purpose of the rule is to prevent "[t]he premature disclosure of the existence of a law enforcement activity to an outside party(who may also be the subject of the investigation) could lead to, among other things, the destruction or alteration of evidence and the tampering with witnesses.”
HHS is accepting comments on the proposed rule through April 18, 2011. To see the proposed rule and instructions on how to submit comments, click here:
http://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=nnKHXl/0/2/0&WAISaction=retrieve
Sources: BNA, Federal Register
Wednesday, September 22, 2010
OIG Report Shows CMS' Failure to Report Adverse Actions to HIPDB
A report from the Department of Health and Human Services Office of the Inspector General (OIG) shows that although the Centers for Medicare & Medicaid Services (CMS) took adverse actions against providers, it failed to report all of these actions to the Healthcare Integrity and Protection Data Bank (HIPDB).
The HIPDB is a repository of "all final adverse actions against health care practitioners, providers, and suppliers." The purpose of the HIPDB is to provide states, federal agencies, and health plans with a resource to help them prevent dealings with practitioners, providers, and suppliers with a history of fraud and abuse.
The report, titled "CMS Reporting to the Healthcare Integrity and Protection Data Bank," revealed that CMS failed to properly report actions taken against laboratories, DME suppliers, and nursing homes. These adverse actions either went unreported even when final action was taken, or were reported outside of the required reporting timeframe, which is about 30 days from the date action was taken, or the date that the reporting entity discovered the action.
The OIG recommended that CMS resolve the problem by providing staff and contractors with better education on reporting requirements. CMS agreed with the findings and pledged to work with the Health Resources and Services Administration (HRSA) to determine what actions are reportable.
This report reminds us that MSPs must be diligent when performing credentialing functions. The data we rely upon is only as good as the reporting source. You cannot evaluate data pulled from one source with a "vacuum mindset." When pulling reports, compare the information you collect along with other reports as well as the provider's history. This investigative step may help you to disclose adverse actions that may not be found in database reports.
To read the full OIG report, click here:
http://www.oig.hhs.gov/oei/reports/oei-07-09-00290.pdf
Source: Department of Health and Human Services, Office of the Inspector General
The HIPDB is a repository of "all final adverse actions against health care practitioners, providers, and suppliers." The purpose of the HIPDB is to provide states, federal agencies, and health plans with a resource to help them prevent dealings with practitioners, providers, and suppliers with a history of fraud and abuse.
The report, titled "CMS Reporting to the Healthcare Integrity and Protection Data Bank," revealed that CMS failed to properly report actions taken against laboratories, DME suppliers, and nursing homes. These adverse actions either went unreported even when final action was taken, or were reported outside of the required reporting timeframe, which is about 30 days from the date action was taken, or the date that the reporting entity discovered the action.
The OIG recommended that CMS resolve the problem by providing staff and contractors with better education on reporting requirements. CMS agreed with the findings and pledged to work with the Health Resources and Services Administration (HRSA) to determine what actions are reportable.
This report reminds us that MSPs must be diligent when performing credentialing functions. The data we rely upon is only as good as the reporting source. You cannot evaluate data pulled from one source with a "vacuum mindset." When pulling reports, compare the information you collect along with other reports as well as the provider's history. This investigative step may help you to disclose adverse actions that may not be found in database reports.
To read the full OIG report, click here:
http://www.oig.hhs.gov/oei/reports/oei-07-09-00290.pdf
Source: Department of Health and Human Services, Office of the Inspector General
Tuesday, August 17, 2010
Cynthia Grubbs, JD, RN Named New DPDB Director
Cynthia Grubbs, R.N., J.D. has been appointed the Director of the Division of Practitioner Data Banks (DPDB). Prior to accepting this position, Ms. Grubbs was Deputy Program Manager and Senior Policy Analyst for SRA International. She was the lead policy expert for SRA’s National Practitioner Data Bank-Healthcare Integrity and Protection Data Bank project team. Ms. Grubbs has also held several prior roles with the NPDB and the Health Resources and Services Administration (HRSA).
In addition to her work with SRA and HRSA, Ms. Grubbs has worked as a staff attorney practicing in the medical malpractice and personal injury fields and has over 8 years of experience as a Registered Nurse.
Ms. Grubbs replaces Acting Director Mark Pincus, who will remain with HRSA.
Ms. Grubbs has been valuable in providing education to NAMSS' members on the NPDB. She presented a webinar on the NPDB's Section 1921 changes this past winter, and is scheduled to present at the NAMSS Annual Conference in October. NAMSS would like to congratulate Ms. Grubbs on her recent appointment.
Source: Health Resources and Services Administration (HRSA)
In addition to her work with SRA and HRSA, Ms. Grubbs has worked as a staff attorney practicing in the medical malpractice and personal injury fields and has over 8 years of experience as a Registered Nurse.
Ms. Grubbs replaces Acting Director Mark Pincus, who will remain with HRSA.
Ms. Grubbs has been valuable in providing education to NAMSS' members on the NPDB. She presented a webinar on the NPDB's Section 1921 changes this past winter, and is scheduled to present at the NAMSS Annual Conference in October. NAMSS would like to congratulate Ms. Grubbs on her recent appointment.
Source: Health Resources and Services Administration (HRSA)
Friday, March 5, 2010
HRSA Replaces Data Bank Management
The Health Resources and Services Administration (HRSA) has confirmed the reassignment of the management team in charge of the Division of Practitioner Data Banks (DPDB), which is in charge of the NPDB and HIPDB reporting systems.
The reassignments come after a report by ProPublica, an independent, nonprofit investigative group revealed inadequate reporting to the databanks by 20 states. This report surfaced as the section 1921 expansion became effective, which requires states to report adverse licensure sanctions.
Darryl Gray, Director of DPDB, has been replaced by Mark Pincus, who served as the program's director prior to Gray's term.
While HRSA recognizes that the databank may have gaps, they still encourage entities to query the NPDB for sanctions, especially now that private healthcare entities have access to sanctions for all licensed healthcare providers under section 1921. HRSA is working with the states to strengthen the information in the NPDB, and announced that states that inadequately report to the system will be publicized in July 2010.
Source: Los Angeles Times
http://www.latimes.com/news/local/la-me-database2-2010mar02,0,2139660.story
The reassignments come after a report by ProPublica, an independent, nonprofit investigative group revealed inadequate reporting to the databanks by 20 states. This report surfaced as the section 1921 expansion became effective, which requires states to report adverse licensure sanctions.
Darryl Gray, Director of DPDB, has been replaced by Mark Pincus, who served as the program's director prior to Gray's term.
While HRSA recognizes that the databank may have gaps, they still encourage entities to query the NPDB for sanctions, especially now that private healthcare entities have access to sanctions for all licensed healthcare providers under section 1921. HRSA is working with the states to strengthen the information in the NPDB, and announced that states that inadequately report to the system will be publicized in July 2010.
Source: Los Angeles Times
http://www.latimes.com/news/local/la-me-database2-2010mar02,0,2139660.story
Thursday, January 28, 2010
NPDB Section 1921 Final Rule Published
The final rule implementing the section 1921 changes to the National Practitioner Data Bank (NPDB) was published in today's Federal Register.
The new rule expands the NPDB, allowing users to query sanctions against all licensed healthcare providers, including nurses, podiatrists, chiropractors, and psychologists.
The rule becomes effective March 1, 2010 and can be found here:
http://frwebgate6.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=692995415457+0+2+0&WAISaction=retrieve.
Source: Federal Register
The new rule expands the NPDB, allowing users to query sanctions against all licensed healthcare providers, including nurses, podiatrists, chiropractors, and psychologists.
The rule becomes effective March 1, 2010 and can be found here:
http://frwebgate6.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=692995415457+0+2+0&WAISaction=retrieve.
Source: Federal Register
Monday, January 25, 2010
Implementation of Section 1921
The Health Resources and Services Administration/Division of Practitioner Data Banks has has announced the implementation of Section 1921.
NAMSS will post the language of the Section 1921 regulation when it is published in the Federal Register this week.
Information on Section 1921 can be found here:
http://www.npdb-hipdb.hrsa.gov/.
"Implementation of Section 1921 will expand the information contained in the National Practitioner Data Bank (NPDB) to include adverse licensure actions taken against all licensed healthcare practitioners and any negative actions or findings by State licensing agencies, peer review organizations, and private accreditation rganizations against all health care practitioners and entities.
This final rule increases the amount of information accessible to hospitals and other organizations through the NPDB. Under the final regulation, private sector (non-Federal) hospitals will now have access to adverse licensure actions taken against all licensed healthcare professionals such as nurses, podiatrists, chiropractors, and psychologists—not just physicians and dentists. At this time, only Federal hospitals have access to this information."
NAMSS will post the language of the Section 1921 regulation when it is published in the Federal Register this week.
Information on Section 1921 can be found here:
http://www.npdb-hipdb.hrsa.gov/.
Monday, December 15, 2008
Section 1921 Implementation Delayed
The Practitioner Data Bank branch of the Health Resources and Services Administration (HRSA) has announced that implementation of Section 1921 of the Social Security Act has been delayed. The final rule was returned to the Secretary of Health and Human Services without any action from the Office and Management and Budget (OMB).
Section 1921 would require the NPDB to be queried for all licensed healthcare professionals including chiropractors, podiatrists, pharmacists, physician assistants, ophthalmologists, professional and paraprofessional nurses, physical therapists, respiratory therapists, and social workers.
It is expected that Section 1921 and other pending final rules from HRSA will be held for review by the incoming Secretary of Health and Human Services.
For more information on Section 1921, click here:
http://www.npdb-hipdb.hrsa.gov/about1921.html
Section 1921 would require the NPDB to be queried for all licensed healthcare professionals including chiropractors, podiatrists, pharmacists, physician assistants, ophthalmologists, professional and paraprofessional nurses, physical therapists, respiratory therapists, and social workers.
It is expected that Section 1921 and other pending final rules from HRSA will be held for review by the incoming Secretary of Health and Human Services.
For more information on Section 1921, click here:
http://www.npdb-hipdb.hrsa.gov/about1921.html
Tuesday, September 16, 2008
Senate Approves Bill to Require Background Checks on Long-Term Care Employees
On September 10, the Senate Finance Committee approved S. 1577, the Patient Safety and Abuse Prevention Act. The bill would require criminal background checks for all employees with direct patient access in nursing homes and long-term care facilities. The bill does not include hospitals or managed care facilities.
In addition to conducting an NPDB-HIPDB query, participating states must screen job applicants in both the state police database and the FBI’s national criminal history database. The goal of the legislation is to increase patient safety by preventing the hire of employees with prior history of abuse or violence.
Senate Special Committee on Aging Chairman Herb Kohl (D-WI) is calling for the bill to be passed by the end of September. Senate Finance Committee Chairman Max Baucus (D-MT) believes the bill can be passed by unanimous consent.
A full version of S. 1577 is available here: http://www.govtrack.us/congress/bill.xpd?bill=s110-1577
In addition to conducting an NPDB-HIPDB query, participating states must screen job applicants in both the state police database and the FBI’s national criminal history database. The goal of the legislation is to increase patient safety by preventing the hire of employees with prior history of abuse or violence.
Senate Special Committee on Aging Chairman Herb Kohl (D-WI) is calling for the bill to be passed by the end of September. Senate Finance Committee Chairman Max Baucus (D-MT) believes the bill can be passed by unanimous consent.
A full version of S. 1577 is available here: http://www.govtrack.us/congress/bill.xpd?bill=s110-1577
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