Program_Memos / 2002 / AB-02-076

Why This Topic Matters

It helps contractors and compliance staff recognize how CMS expected HIPDB to support provider oversight workflows and where it fit within broader program integrity operations.

Article Sections

1. Overview of the HIPDB

   Introduces the data bank, its purpose, and the federal organizations associated with its operation and oversight. Summarizes the broad categories of adverse action information it was designed to capture.

2. Access, registration, and use requirements

   Describes how Medicare contractors obtain access, the registration process, and general expectations for online querying. Also notes security, fees, and related system access limitations.

3. HIPDB use by Carrier and FI Benefit Integrity units

   Explains the role of the data bank in benefit integrity workflows and the types of referrals that should be reviewed through the system.

4. HIPDB use by Carrier and FI Enrollment units

   Covers how the data bank fits into enrollment screening activities and how results may affect processing of applications.

5. HIPDB use by FI and Carrier MR units

   Discusses how medical review staff were expected to consider the system, along with general suggestions for incorporating it into review activities.

6. Dates, contacts, and attachment

   Lists the memorandum’s effective date, implementation date, retention guidance, and contact information. Also includes the attachment reference naming the related data bank titles.