HHS OIG list of terminated Medicare providers

Evan Anderson filed this request with the Department of Health and Human Services Office of Inspector General of the United States of America .
Tracking #

031420187071

Status
Completed

Communications

From: Evan Anderson

To Whom It May Concern:

This is a request under the Freedom of Information Act. I hereby request the following records:

The most recent copy of the list of terminated Medicare providers.

The requested documents will be made available to the general public, and this request is not being made for commercial purposes.

In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 20 business days, as the statute requires.

Sincerely,

Evan Anderson

From: Department of Health and Human Services Office of Inspector General

Dear Mr. Anderson:

This is in response to the March 13, 2018 Freedom of Information Act (FOIA) request you submitted to the Department of Health and Human Services, Office of Inspector General (OIG), requesting the list of terminated Medicare providers.

The records you seek are not housed within the OIG. We have taken the liberty of referring your request to the Centers for Medicare and Medicaid Services (CMS) FOIA Office for processing and direct reply to you. You may contact the CMS FOIA Office at the following address:

Centers for Medicare and Medicaid Services (CMS)
Freedom of Information Officer
North Building, Room N2-20-06
7500 Security Boulevard
Baltimore, Maryland 21244
Phone: 410-786-5353
FOIA Officer: Hugh Gilmore
FOIA Public Liaison: Joseph Tripline
hugh.gilmore@cms.hhs.gov<mailto:hugh.gilmore@cms.hhs.gov>
joseph.tripline@cms.hhs.gov<mailto:joseph.tripline@cms.hhs.gov>

There is no charge for FOIA services in this instance because billable fees are under the Department's $25 cost effective threshold.

For your information, Congress excluded three discrete categories of law enforcement and national security records from the requirements of the FOIA. See 5 U.S.C. § 552(c) (2006 & Supp. IV (2010). This response is limited to those records that are subject to the requirements of the FOIA. This is a standard notification given to all our requesters and should not be taken as an indication that excluded records do, or do not, exist.

Sincerely,

//signed-March 14, 2018//
Sandra Servin-Solis
Government Information Specialist
Office of Inspector General
Department of Health and Human Services
330 Independence Avenue, SW
Washington, DC 20201
v. 202-619-2541

From: Department of Health and Human Services Office of Inspector General

Dear Mr. Anderson,

We are in receipt of your FOIA request dated 3/13/2018. Please clarify if you are requesting the most recent list of terminated Medicare providers in a specific state, nationwide, or perhaps a standard annual list? Pleas also include a timeframe for our office to search for the information i.e. January 1, 2017 to January 1, 2018.

I will place your request in a "toll" status until I hear from you. If I do not receive a reply from you within 15 business days, your request will be administratively closed.

Thank you,

Breita M. Gillard
Centers for Medicare & Medicaid Services
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Division of FOIA Analysis C
7500 Security Blvd, Mail Stop: N2-20-16
Baltimore, MD 21244-1850
Direct: 410-786-5126
Fax: 443-380-7260
Email: breita.gillard@cms.hhs.gov

From: Evan Anderson

Hi there,

Thank you for the response. I am seeking a nationwide list. I am interested in learning of what providers/practitioners are currently terminated from Medicare. If I say that the time frame of my request is from January 1, 2017 to the date this request is processed, will that help me get what I am looking for?

Is it possible that someone who was terminated from Medicare in the past could be able to re-enroll in the future? If not, then I'll be happy with simply obtaining the current list.

Thank you,
Evan

From: Department of Health and Human Services Office of Inspector General

Hello,

I will send your request to the appropriate component for search. I cannot determine when the request will be completed, and unfortunately cannot answer your question regarding reenrollment of terminated Medicare providers since I am not the program office who actually are the experts.

Please confirm the timeframe and I will send your request forward to be processed.

Thanks,

Breita

Breita M. Gillard
Centers for Medicare & Medicaid Services
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Division of FOIA Analysis C
7500 Security Blvd, Mail Stop: N2-20-16
Baltimore, MD 21244-1850
Direct: 410-786-5126
Fax: 443-380-7260
Email: breita.gillard@cms.hhs.gov

From: Department of Health and Human Services Office of Inspector General

Hello,

Please call me so we can discuss.

Breita M. Gillard
Centers for Medicare & Medicaid Services
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Division of FOIA Analysis C
7500 Security Blvd, Mail Stop: N2-20-16
Baltimore, MD 21244-1850
Direct: 410-786-5126
Fax: 443-380-7260
Email: breita.gillard@cms.hhs.gov

From: Department of Health and Human Services Office of Inspector General

Please give me a call so we can discuss your case. Thanks.

Breita M. Gillard
Centers for Medicare & Medicaid Services
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Division of FOIA Analysis C
7500 Security Blvd, Mail Stop: N2-20-16
Baltimore, MD 21244-1850
Direct: 410-786-5126
Fax: 443-380-7260
Email: breita.gillard@cms.hhs.gov

From: Evan Anderson

Hi there,

I apologize for not calling you yet. I will try to do so tomorrow.

Thanks,
Evan

From: Department of Health and Human Services Office of Inspector General

Mr. Anderson,

Is this what you are seeking? Please let me know.

https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Termination-Notices.html

Thanks,

Breita

Breita M. Gillard
Centers for Medicare & Medicaid Services
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Division of FOIA Analysis C
7500 Security Blvd, Mail Stop: N2-20-16
Baltimore, MD 21244-1850
Direct: 410-786-5126
Fax: 443-380-7260
Email: breita.gillard@cms.hhs.gov

From: Evan Anderson

Hi Breita,

Thank you for this. It is close to what I am looking for. I'm hoping for a spreadsheet/list of individuals (i.e. practitioners) and organizations (e.g. hospitals) who are currently unable to bill Medicare because they have been terminated. What you sent me are recent notices of termination. I am looking for names/facilities that have been terminated from Medicare and cannot enroll in Medicare currently. If it helps, I learned about it from this article: https://www.reuters.com/investigates/special-report/usa-medicaid-fraud/. The second paragraph under the sidebar "Bills, bills, bills: Analyzing Medicare, Medicaid records" alludes to a "terminated-providers list." The caption of one of the photos reads: "The U.S. Health and Human Services Office of the Inspector General keeps a list of terminated Medicare providers, but widespread lack of identification numbers makes the list hard to use." Beneath that: "State Medicaid officials said the system CMS now has in place – an Excel file updated every two weeks – allows states to share more detailed information on providers, like Social Security numbers. But fortnightly updates mean state officials don’t always get the information as soon as they would like."

I hope that clarifies it.

Best,
Evan

From: Department of Health and Human Services Office of Inspector General

An interim response, stating the request is being processed.

From: Department of Health and Human Services Office of Inspector General

Hello,

This case is now assigned to James Olin at 410-786-3677. Please contact him for any updates.

Thank you,

Breita M. Gillard
Centers for Medicare & Medicaid Services
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Division of FOIA Analysis C
7500 Security Blvd, Mail Stop: N2-20-16
Baltimore, MD 21244-1850
Direct: 410-786-5126
Fax: 443-380-7260
Email: breita.gillard@cms.hhs.gov

From: Evan Anderson

Hi there,

It's been 7 months since I last heard from your office. Can I please have an update on this request?

Evan

From: Department of Health and Human Services Office of Inspector General

Good Morning,

Please contact James Olin at 410-786-3677. He has been assigned to the case as stated below in my previous email.

Thank you,

Breita M. Gillard
Centers for Medicare & Medicaid Services
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Division of FOIA Analysis B
7500 Security Blvd., Mail Stop: N2-20-16
Baltimore, MD 21244-1850
Direct: 410-786-5126
Email: breita.gillard@cms.hhs.gov

From: Evan Anderson

Do you have his email address?

Evan

From: Department of Health and Human Services Office of Inspector General

James.olin@cms.hhs.gov

Breita M. Gillard
Centers for Medicare & Medicaid Services
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Division of FOIA Analysis B
7500 Security Blvd., Mail Stop: N2-20-16
Baltimore, MD 21244-1850
Direct: 410-786-5126
Email: breita.gillard@cms.hhs.gov

From: Evan Anderson

Hi there,

Can I please have an update on this request? Number 031420187071.

Thanks,
Evan

From: Department of Health and Human Services Office of Inspector General

Evan,

Please note I work for CMS and not the Office of Inspector General.

We received the data you requested this morning. Is it possible to e-mail you our response to this e-mail address?

Jay

Jay Olin
Director, Division of FOIA Analysis - C
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Centers for Medicare & Medicaid Services
Direct: 410-786-3677
Fax: 443-380-7260
E-mail: james.olin@cms.hhs.gov<mailto:james.olin@cms.hhs.gov>

From: Evan Anderson

Yes, you may send it to this email address.

Thank you,
Evan

From: Department of Health and Human Services Office of Inspector General

Our response is attached.

Jay Olin

Jay Olin
Director, Division of FOIA Analysis - C
Office of Strategic Operations and Regulatory Affairs
Freedom of Information Group
Centers for Medicare & Medicaid Services
Direct: 410-786-3677
Fax: 443-380-7260
E-mail: james.olin@cms.hhs.gov<mailto:james.olin@cms.hhs.gov>

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