By year-end, federal investigators will have access to a database with all active healthcare fraud cases and any investigations that have taken place since 1993.
The fraud investigation database will be accessible by investigators from HHS' inspector general's office, the FBI and the U.S. Justice Department. Providers and the public won't be able to access the information, nor are there procedures for providers to check whether they appear in the compilation.
The database, maintained by HCFA, is up and running but will not be completed until year-end. The agency has been working on the project for about two years.
The listing currently includes almost 1,800 cases, said George Jacobs, HCFA's acting director of the office of benefits integrity. Because some providers may be involved in several cases, the number of providers that appear in the database is likely to be lower than the number of cases.
HCFA has notified its Medicare contractors they must submit information by year-end on active fraud cases, cases referred to the inspector general's office and cases that date back to fiscal 1993. Jacobs said he expects more than 2,000 cases in the database.
Information will include the organization under investigation, Medicare identification number, the provider's location and details of the case. Details about procedure codes under review and the dollar amounts in question also will be included.
Fred Abbey, a partner with the consulting firm Ernst & Young in Washington, said providers should be concerned because HCFA has no system in place to inform providers of the problems it uncovers.
"If a provider is not knowingly and willingly committing fraud . . . shouldn't the government want to inform providers of problems and the lessons they have learned so providers can review their systems?" Abbey asked.
According to Jacobs, the database will give investigators the ability to "look for patterns in what is being investigated," such as geographic locations, types of services being abused or scams being perpetrated.
The database now includes only Medicare data but eventually will be expanded to cover Medicaid fraud, Jacobs said.