When Physicians Don’t Self-Report Criminal or Civil Charges to Licensing Boards, FACIS Can Bridge the Gap

Medical and licensing boards fulfill two primary regulatory functions: licensure and discipline. In most cases, they are lacking in funding, staff, public board members, and authority to carry out these important responsibilities. In addition to issuing, restricting, and revoking licenses, licensing boards oversee continuing education, re-licensure, quality oversight, and mid-career licensure.

Each licensing board, within its own silo, relies on physicians and hospitals to report disciplinary actions, licensing issues, and criminal behavior. If there are delays, or if the report is never filed, the licensing board is left to assume that the physician is in good standing. That leaves a lot to chance. Would a practicing physician self-report their adverse actions if there is a chance that he or she could lose their license and have their privileges removed? Can a hospital be aware of every licensed practitioner’s adverse action when we know that self-reporting is unreliable?

To add to the equation, it is rare for these different licensing boards to cross report or for each state to cross report to a centralized data set that is searchable across some 900 health care taxonomies and nearly 10,000 taxable jurisdictions in the U.S.

The end goal of protecting patients is greatly enhanced by utilizing the data contained in FACIS^® because data from licensing and medical boards is often incomplete, difficult to search, or not up-to-date. Verisys Corporation’s Fraud Waste Control Information System (FACIS), a proprietary health care data set, was created for the express purpose of housing a centralized database of excluded, disciplined, sanctioned, and debarred providers.

In an effort to provide an accurate provider profile, FACIS collects data on indictments and convictions published by the U.S. and individual state’s Attorney General offices. Using FACIS gives your organization a heads up on what could ultimately become a sanction or exclusion for one of your providers. FACIS collects publicly released criminal charges which can eliminate the risk of having a sanctioned or excluded provider on your staff who never self-reported their adverse action to licensing boards or to the National Provider Data Bank (NPDB).

Verisys data specialists collect, verify, and aggregate data from thousands of primary sources, so one search of FACIS^®, the comprehensive, national data set, provides historical records dating from the early 1990’s up to the most current, real-time records. With this level of extensive data available to those hiring and contracting with health care providers, and to licensing boards, much of the fraud and patient abuse taking place can be stopped in its tracks.

Learn more about how Verisys can assist your HCOs in meeting all government and regulatory standards.

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