Posts Tagged Inaccurate Provider Data

Inaccuracies in Medicare and Medicaid Provider Data Highlighted

Friday, June 28th, 2013 | Permalink

A May 2013 Office of Inspector General for the Department of Health and Human Services report* analyzed the Provider data files of Medicare and found a very high error rate.

To quote portions of the Executive Summary:

“Medicare provider data in NPPES (National Plan and Provider Enumeration System) and PECOS (Provider Enrollment, Chain and Ownership System) were often inaccurate. In NPPES, provider data were inaccurate in 48% of records…. in PECOS, provider data were inaccurate in 58% of records…Addresses, which are essential for contacting providers and identifying trends in fraud, waste, and abuse, were the source of most inaccuracies and inconsistencies. Finally, CMA did not verify most provider information in NPPES and PECOS….(more…)

 

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