decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Fraud and Abuse / Health care fraud and abuse data collection program
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Article Overview
This article describes a federal health care fraud and abuse data collection program established by HHS, including the categories of information gathered about providers, suppliers, and practitioners and the types of final adverse actions included. It is relevant for compliance, credentialing, and fraud and abuse monitoring stakeholders who need a broad understanding of what the database contains and who may access it.
Why This Topic Matters
Understanding what is captured in the HHS data collection program helps organizations involved in compliance, payer oversight, credentialing, and provider screening recognize the scope of reportable adverse action information.
What You Will Learn
- The purpose of HHS’s health care fraud and abuse data collection program
- What categories of information are included in the database
- Which types of final adverse actions are encompassed
- Who can access the collected information at a general level
Who Should Read This
- Compliance professionals
- Credentialing staff
- Health plans
- Federal and state government agencies
- Healthcare administrators
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