Few HMOs Report Disciplinary Actions Filed Against Doctors

Federal law requires health maintenance organizations to report disciplinary actions taken against doctors and dentists for incompetence or misconduct. But few appear to be doing so.

In the last 10 years, 84% of HMOs didn’t report even one such action to the National Practitioner Data Bank, a new federal report says. Congress created the repository in 1986 to help keep track of bad players who tried moving among states.

The inspector general of the federal Department of Health and Human Services found that HMOs consulted the databank 8 million times in the 1990s to check on doctors’ credentials. Yet they submitted only 715 reports of such incidents as doctors operating on the wrong side of the body, doctors having sex with their patients, abusing drugs or improperly prescribing drugs.

The report’s authors said that having HMOs file fewer than 1,000 such reports qualifies as non-reporting--especially since the Institute of Medicine found that medical errors kill 44,000 to 98,000 Americans each year.

Some HMOs contended they thought they were required to file disciplinary reports with state licensing boards, not to the databank. The authors of the new report recommended that federal officials clarify the requirements and ensure compliance.

The databank remains closed to the public. Patients can ask about a doctor’s disciplinary history by going to the Federation of State Medical Boards in Euless, Texas. That Web site is https://www.docinfo.org and each inquiry costs $9.95.