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Medicare Compliance & Reimbursement

Fraud & Abuse:

PLANS, AGENCIES GET PRICE CUT ON HIPDB

Published on Wed Apr 30, 2003

Health plans and government agencies soon will get a price cut when they run a provider query through the HHS Office of Inspector General's Healthcare Integrity and Protection Data Bank. According to a April 22 Federal Register notice, the agency is cutting the per-query fee from $5 to $4.25 to better reflect the costs of maintaining the data repository, which contains information on health care-related court judgments, criminal convictions, licensure actions and other kinds of sanctions levied against health care providers. The HIPDB is intended to deter fraud and abuse by giving certain organizations a way to identify providers who've had a troubled past. The new fee rate goes into effect July 1. While health care providers themselves don't have access to the database (access is limited to health plans and government agencies), they can do a self-query to see what the HIPDB says about them. The fee for a self-query is $10. To see the notice, go to www.access.gpo.gov/su_docs/fedreg/a030422c.html. For more information on the HIPDB, go to http://www.npdb-hipdb.com/hipdb.html.  
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