June/July 2001

Do HMOs Fail To Report Doctors’ Mistakes?

Washington - Many managed-care organizations are failing to report their physicians' malpractice claims and disciplinary actions to a government database that aims to protect patients from poorly performing doctors, a federal study has found.

Health maintenance organizations (HMOs) reported only 715 such actions from 1990 to 1999, at a time when the insurance plans became the dominant form of healthcare in the United States, according to a recent report by the inspector general of the Department of Health and Human Services. Nearly 100 million Americans are enrolled in such plans.

The report also found 84% of the 1,401 HMOs in the study didn't report a single action to the National Practitioners Data Bank.

Carmella Bocchino, vice president of the American Association of Health Plans, said many HMO officials apparently did not realize they were required to tell the government when doctors were disciplined. The report did find it ``plausible'' some reporting lapses could be attributed to misunderstandings about reporting requirements.

The data bank was created by a 1986 federal law that requires insurance companies, hospitals and state and federal regulators to report malpractice payments and disciplinary actions against all health-care providers.

Source: Associated Press

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