What is an Exclusion Waiver and Who May Apply for one?
We have previously discussed that once a provider is excluded he may not furnish items or services paid for…
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 MoreWhat is an Exclusion Waiver and Who May Apply for one?
California Exclusion List Screening Requirements
What are the California Exclusion List Screening requirements? The Medi-Cal Program will not pay for any item or…
Pennsylvania Medicheck Preclusion List: A Provider’s Guide to Screening
The Pennsylvania Precluded Provider List, commonly referred to as “Pennsylvania Medicheck ,” identifies individuals and entities who have…
How the LEIE, GSA/SAM, and State Exclusion Lists Differ; And Why They Need to be Screened
Exclusions and debarments are powerful administrative sanctions imposed by Federal and State agencies. They are intended to protect…
A Provider’s Guide to the GSA SAM Database.
Health care providers and suppliers should also screen the General Services Administration’s (GSA’s) System for Award Management (SAM) database to ensure that the individuals and entities they employ or do business with have not been suspended or debarred from doing business with certain federal agencies and the programs they administer.
About the Medi-Cal Suspended and Ineligible Provider List
California’s Medi-Cal Suspended and Ineligible Provider List is Designed to Safeguard Beneficiaries and Protect the Financial Integrity of…
The Legal Guide to OIG Exclusions
This article is an updated version of “A Provider’s Guide to OIG Exclusions: Federal Exclusion Regulations and Enforcement Authorities,…
What is an OIG Exclusion?
OIG Exclusions are powerful enforcement sanctions that bar an individual or entity from any participation in Federal and…