OIG reports Medicare enrollment databases riddled with errors

On May 28 the Office of the Inspector General (OIG) issued a report recommending improvements to ensure that provider enrollment data are accurate, complete and consistent.  During its audit, the OIG identified that an estimated 58% of enrollment records in the Provider Enrollment, Chain and Ownership System (PECOS) contained errors. In addition, 48% of records in the National Plan and Provider Enumeration System (NPPES) contained errors.  Accuracy of information in the PECOS and NPPES has become even more important as these databases are used as resources for data posted on the Physician Compare website.

The Centers for Medicare & Medicaid Services (CMS) have already begun an effort to correct inaccuracies in the enrollment databases.  This effort has included a revalidation campaign for providers and suppliers that enrolled prior to March 25, 2011.  In its report, the OIG recommended additional efforts to ensure the accuracy of physician enrollment information.  These recommendations include: establishing program integrity safeguards; requiring more verification of enrollment data; and detection and correction of inaccurate and complete data for both new and established records.

2013-06-20T00:00:00+00:00 June 20th, 2013|Clinical Resources|