CMS has made no effort to require states to report banned providers, and when states did report, them the data was often unreliable or incomplete, according to the report.
State Medicaid administrators are encouraged to report to the database medical providers who have been convicted of major crimes, have lost their medical license or were otherwise disciplined. They can then use the system to identify providers in their own Medicaid program who were terminated in other states.
According to the report, 17 states and the District of Columbia had reported no banned providers as of June 2013.
The auditor found one-third of providers in the database had not been terminated, but had died, retired, left the state or stopped working with Medicaid of their own accord. One-fourth of the records lacked a provider address, and one-third lacked a provider specialty.
In response to the audit, CMS has begun requiring states to submit termination letters for each provider entered in the shared data system.
More Articles on Medicaid Fraud:
OIG: Medicaid Fraud Control Units Recovered $2.5B in 2013
Arkansas Case Narrows Scope of State Medicaid Fraud Statute
Duke Health Reaches $1M Settlement in Fraudulent Billing Case
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