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Expanded Federal Authority Needed To Protect Medicare and Medicaid Patients From Health Practitioners Who Lose Their Licenses

HRD-84-53 Published: May 01, 1984. Publicly Released: May 01, 1984.
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Highlights

GAO obtained information on health care practitioners in three states who had their licenses revoked or suspended to determine whether they were relocating and continuing to treat patients under Medicaid and Medicare programs in other states.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services should revise the HHS practitioner exclusion legislative proposal so that it includes provisions authorizing HHS to sanction nationally Medicare and Medicaid practitioners who are: (1) excluded by any state Medicaid program; (2) excluded by Medicare; (3) convicted of crimes involving any federal or nonfederal health program; or (4) sanctioned by any state licensing board.
Closed – Implemented
HHS proposed legislation included all of the items that GAO recommended. The recommended GAO legislation was included in P.L. 100-93.
Department of Health and Human Services The Secretary of Health and Human Services should direct the HHS Inspector General to include in the Health Care Program Violation Information System all practitioners sanctioned by state licensing boards.
Closed – Implemented
Bills were reintroduced in the Senate and House which would require HHS to have the recommended information available. HHS was required to establish the recommended database by P.L. 100-93.

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Topics

Health Care
Crimesstate relationsFraudHealth care servicesMedicareInformation systemsLicensesMedicaidPhysiciansSanctions