Which of the following best describes the purpose of HIPDB?

Which of the following best describes the purpose of HIPDB?

• A. Regulate hospital licensing
• B. Combat fraud and abuse in health insurance and health care delivery; promote quality of care
• C. Manage patient billing
• D. Set clinical guidelines

Answer: (B)

The main idea is that HIPDB exists to curb fraud and abuse in health care and health insurance while helping protect patients by promoting quality of care. It does this by collecting and sharing information about disciplinary actions, license suspensions or revocations, sanctions, and other adverse actions against health care providers and entities. With this information, health plans, hospitals, and other authorized organizations can screen applicants and detect patterns of misconduct, reducing the chance that problematic providers participate in care or billing. The other activities—regulating hospital licensing, managing patient billing, and setting clinical guidelines—are handled by licensing boards, billing processes, and guideline-developing bodies, not HIPDB.

The main idea is that HIPDB exists to curb fraud and abuse in health care and health insurance while helping protect patients by promoting quality of care. It does this by collecting and sharing information about disciplinary actions, license suspensions or revocations, sanctions, and other adverse actions against health care providers and entities. With this information, health plans, hospitals, and other authorized organizations can screen applicants and detect patterns of misconduct, reducing the chance that problematic providers participate in care or billing. The other activities—regulating hospital licensing, managing patient billing, and setting clinical guidelines—are handled by licensing boards, billing processes, and guideline-developing bodies, not HIPDB.