Student Loan Default Becoming a Top Reason for Exclusion
Providers are often surprised to learn that a person can be excluded from participation in federal health care…
Category Exclusion Screening
Exclusion screening is the federal and state compliance obligation to verify that healthcare employees, vendors, and contractors are not barred from participating in Medicare, Medicaid, or other federally-funded programs. Every healthcare provider that bills a federal program is required to screen upon hire and monthly thereafter against the OIG LEIE, GSA/SAM, and all 44 state Medicaid exclusion lists. Failure to screen exposes providers to civil money penalties of up to $24,947 per violation, overpayment liability, and potential False Claims Act exposure. This section of the site is the definitive hub for exclusion screening compliance: the pillar guides, state-by-state requirements, enforcement trends, and the regulatory framework explained by the former federal prosecutors who built it.
Read MoreStudent Loan Default Becoming a Top Reason for Exclusion
Why Should I Screen Against Every State Exclusion List?
The Office of the Inspector General (OIG) issued a Special Advisory Bulletin in May 2013, which states that…
Who Should Be on my OIG Exclusion Screening List?
I. Federal and State Agencies Conducting Audits As many healthcare providers and suppliers have painfully learned over the…
Home Health and Nursing Home Facilities a Major Target for OIG Enforcement
I. Civil Monetary Penalties Twenty-five out of the fifty-five exclusion enforcement actions reported in 2014 have occurred in…
Must Haves for a Proper Exclusion Screening Process
At Exclusion Screening, LLCSM, we know the ins-and-outs of the exclusion screening process. In our opinion, an effective…
The Administrative Process of Imposing an OIG Exclusion
I. Mandatory OIG Exclusions When the Office of Inspector General (OIG) considers imposing a mandatory exclusion, it sends…
Do I Really Need to Screen My Employees and Vendors Each Month?
I. OIG Recommends Monthly Screening While there is not a formal regulation that mandates monthly exclusion screening, OIG…
CMP Liabilities: Why Are Some Much Higher Than Others?
A quick review of the Office of Inspector General’s (OIG) exclusion enforcement actions might make one wonder why the…