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…
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 MoreDo I Really Need to Screen My Employees and Vendors Each Month?
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…
Alert to Florida Providers Regarding Screening
Florida Agency for Health Care Administration (AHCA) and Office of Inspector General maintains the Florida Medicaid Suspended Providers…
Gary Cantrell Testimony: Failures to Report Adverse Licensing Actions Leads to Gaps in the OIG-LEIE
HHS/OIG Deputy Inspector General Gary Cantrell testified earlier this year that States are failing to report all of…
CMS Finds Fault with Exclusion Information Sharing Between States
I. Take It from CMS: If You’re Excluded in One State, You’re Excluded in All States Section 6401(b)(2)…
Exclusion Databases: How Difficult Is Screening and Verifying?
I. Which Exclusion Databases Do I Need to Screen? The Office of Inspector General (OIG) recommends that you…
2015 OIG Work Plan: Prevention of Grant Awards to Excluded Persons and Entities
I. Concerns of the 2015 OIG Exclusion Work Plan The Office of Inspector General (OIG) expressed concern regarding…
OIG Provides Guidance on Disclosures for Conduct Involving Excluded Persons in the Updated Self-Disclosure Protocol
I. Provider Self-Disclosure Protocol: New Guidance Sheds Light on Disclosure On April 17, 2013, the Office of the…