Complaint tracker goes after Medicare abuses

 

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The Health and Human Services Department will put a new national complaint system into operation this month to track reports of alleged abuses by Medicare and Medicaid providers and suppliers.

The Health and Human Services Department will put a new national complaint system into operation this month to track reports of alleged abuses by Medicare and Medicaid providers and suppliers.

The Aspen Complaints/Incidents Tracking System (ACTS) will manage complaint submissions, incident tracking, investigations and actions taken against health care facilities regulated by the Centers for Medicare and Medicaid Services. The facilities include nursing homes, hospitals, home health agencies, hospices, physical therapy centers, laboratories and community mental health centers.

For instance, the agency investigates complaints of neglect and abuse of nursing home residents and improper use of residents' property. The complaint system is designed to assure quality health care in a safe environment for elderly and low-income patients.

'The intent of the ACTS tracker is to collect more complete data than previously from state survey agencies to help us in our efforts to detect problems in nursing homes and other care settings,' a CMS spokesman said. More data will make monitoring and oversight activities more effective, he said.

Nothing extra

The new complaint system will eliminate duplicate data collection in the states and help them prioritize cases, a CMS official said.

'ACTS will standardize reported complaints and incidents so that states can also use the information for licensing and accreditation,' CMS administrator Thomas Scully told lawmakers recently.

Data gathered for the ACTS system at a CMS data center in Baltimore will be more comprehensive than that for the previous system. The ACTS applications run on Microsoft Windows 2000 servers and use an Oracle database. Complaint records will be stored on the magnetic disks and saved to magnetic tape backup nightly, the agency said.

Antivirus software has been installed on both the workstations and Windows 2000 servers, and states have installed firewalls on servers using the data. CMS protects the privacy of the records'which contain patients' names, addresses and Medicare numbers'with controlled access, PIN and password authentication, restricted hours of use and automatic inactivity log-out.

CMS published the notice of its final ACTS plans, including data security and privacy protections, in the Federal Register last month. The agency has been testing a pilot version of the complaint system, proposed in January, for several months.

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