Proposed Rule Would Combine Data Banks for Practitioner, Health Care Integrity Data

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Proposed Rule to Combine Data on Fraud, Abuse, and Actions Against Physicians  

Key Development: Data from the Healthcare Integrity and Protection Data Bank would be transferred to the National Practitioner Data Bank.

Potential Benefit: The consolidation is designed to eliminate duplicative data reporting and access requirements.

The Health Resources and Services Administration has proposed transferring all data in the Healthcare Integrity and Protection Data Bank to the National Practitioner Data Bank and ceasing operations of the Healthcare Integrity and Protection Data Bank.

According to a proposed rule that will appear in the Feb. 15 Federal Register, information previously collected and disclosed through the Healthcare Integrity and Protection Data Bank will be collected and disclosed through the National Practitioner Data Bank, consolidating the collection and disclosure of information from both data banks into one part of the Code of Federal Regulations.

The consolidation is a result of Section 6403 of the Patient Protection and Affordable Care Act, and is designed to eliminate duplicative data reporting and access requirements, HRSA said.

The proposed rule is part of a Department of Health and Human Services effort to reduce regulatory burdens as required under an executive order issued by President Obama in January 2011.

Under the proposed rule, the HHS secretary would establish a transition period for the data transfer and closing of the Healthcare Integrity and Protection Data Bank (HIPDB).

No new reporting requirements would be added as a result of the consolidation, and all actions currently reported to both data banks would be reported only to the NPDB.

Comments on the proposed rule are due 60 days after publication.

Access to Data, Security of Data Will Remain the Same.

Requirements pertaining to who may access the data bank and how the data will be protected remain the same after data are transferred to the National Practitioner Data Bank, according to the proposed rule.

The National Practitioner Data Bank was established by the Health Care Quality Improvement Act of 1986 (HCQIA).

The NPDB is authorized to collect reports of:

  • adverse licensure actions against physicians and dentists (including revocations, suspensions, reprimands, censures, probations, and surrenders);
  • adverse clinical privileges actions against physicians and dentists;
  • adverse professional society membership actions against physicians and dentists;
  • Drug Enforcement Administration (DEA) certification actions;
  • Medicare or Medicaid exclusions; and
  • medical malpractice payments made for the benefit of any health care practitioner.

Organizations that have access to this data system include hospitals, other health care entities that have formal peer review processes and provide health care services, state medical or dental boards, and other health care practitioner state boards.

HIPDB served as a national health care fraud and abuse data collection program for the reporting and disclosure of certain final adverse actions taken against health care practitioners, providers, or suppliers.

HRSA emphasized that the consolidated data bank will still follow privacy and security guidelines from the National Institute for Standards and Technology. Specifically, according to the proposed rule, the consolidated data bank would have extensive operational, management, and technical controls to ensure the security of the system and protect the data in the system.

The proposed rule is available at http://op.bna.com/mdw.nsf/r?Open=plon-8rgs9u.