Nevada Medicaid Exclusion List & Screening Requirements
What is the Nevada Medicaid Provider Sanctions/Exclusions list, and how does it differ from the OIG LEIE?
The Nevada Medicaid Provider Sanctions/Exclusions is a separate exclusion list maintained by the state of Nevada. It covers providers excluded or terminated from Nevada Medicaid specifically. The OIG LEIE is the federal exclusion list covering Medicare, Medicaid, and all federal health programs. Providers must screen both lists, along with GSA/SAM, to ensure compliance and avoid federal penalties. Note: Screening only one list is insufficient for compliance. View Nevada’s official list.
How often must organizations screen against the Nevada Medicaid Provider Sanctions/Exclusions list?
Screening must be performed monthly, on hire and every month thereafter. CMS State Medicaid Director Letters #08-003 and #09-001 require monthly screening of every employee, contractor, and vendor who contributes to a claim—including billers, coders, and managing employees. Note: Failure to maintain monthly screening can result in federal penalties. See all state Medicaid exclusion lists.
Do I need to screen the Nevada list if my organization is not located in Nevada?
Yes. If you bill Nevada Medicaid or employ Nevada-licensed staff, you are required to screen against the Nevada Medicaid Provider Sanctions/Exclusions list. An exclusion in one state can also trigger sanctions in others under Section 6501 of the Affordable Care Act. Note: Screening obligations may extend across state lines; consult compliance specialists for edge cases.
What penalties can result from hiring or contracting with excluded individuals in Nevada?
The OIG can impose civil monetary penalties of up to ,947 per item or service that an excluded individual contributed to. Penalties can accumulate quickly—a single excluded employee submitting claims over several months may result in six- or seven-figure exposure. Recent Nevada settlements include 3,992 (home health agency, Nov 2023), 0,464 (hospital, Aug 2022), and ,855 (healthcare services, Aug 2022). Self-disclosure reduces but does not eliminate the penalty. Note: Penalties may vary based on claim volume and reporting; see historical OIG settlements for details.
Features & Capabilities of Exclusion Screening
What services does Exclusion Screening offer to help organizations comply with exclusion list requirements?
Exclusion Screening provides comprehensive exclusion screening and verification services, including employee screening, vendor and contractor screening, a compliance hotline, and proprietary SAFER™ software. The SAFER™ software automates screening across federal and state lists, offers daily updates, advanced algorithms to reduce false positives/negatives, and scalability for organizations of all sizes. Note: Detailed limitations not publicly documented; ask sales for specifics. See full service overview.
How does Exclusion Screening's SAFER™ software improve compliance screening?
The SAFER™ software automates exclusion screening, updates compliance data daily, and uses advanced algorithms to handle inconsistent data formats and duplicate names. This reduces false positives and negatives, saving time and resources. The system is scalable for both small practices and large healthcare systems. Note: Best fit for organizations seeking automation; teams needing manual review may want to consider alternatives. Learn more about SAFER™.
Does Exclusion Screening offer vendor and contractor screening?
Yes. Exclusion Screening verifies vendors and contractors for compliance, helping organizations reduce regulatory risks and maintain compliant business relationships. This service is critical for organizations with extensive vendor networks. Note: Service scope may vary; contact Exclusion Screening for custom solutions. Vendor screening details.
What is the Compliance Hotline, and how does it help organizations?
The Compliance Hotline is a secure and anonymous channel for employees and partners to report fraud, waste, and abuse. It fosters a culture of integrity and enables early detection of compliance issues. Note: Hotline effectiveness depends on organizational adoption; limitations not publicly documented. Compliance Hotline info.
Pricing & Implementation
How is Exclusion Screening's pricing determined?
Pricing is competitive and customized based on the specific monitoring lists required and the volume of screenings needed. This tailored approach ensures organizations only pay for what they need, making services cost-effective and scalable. Note: Exact pricing details are not publicly documented; request a quote for specifics. Contact for pricing.
How quickly can organizations implement Exclusion Screening's services?
New clients can begin screening within 1 day, which is faster than many other vendors. The SAFER™ software is designed for easy integration and automation, with support from compliance specialists to ensure a smooth setup. Note: Implementation speed may vary for complex organizations; consult sales for details. About implementation.
Use Cases & Business Impact
What types of organizations benefit most from Exclusion Screening?
Healthcare providers—including small practices, large healthcare systems, hospitals, clinics, and organizations with high compliance risks—benefit from Exclusion Screening. Roles such as compliance officers, risk managers, legal teams, and operational managers are primary users. Organizations with extensive vendor networks or those focused on ethical practices also gain value from tailored screening and compliance hotline services. Note: Best fit for healthcare sector; non-healthcare organizations may require alternative solutions. See target audience.
What business impact can organizations expect from using Exclusion Screening?
Organizations can expect improved compliance, reduced risk of penalties, cost savings through automation, operational efficiency, and enhanced integrity. The SAFER™ software and compliance hotline help avoid legal and financial repercussions, streamline compliance processes, and foster a culture of trust. Note: Impact may vary based on organizational adoption and compliance complexity. Business impact details.
Case Studies & Industry Proof
Are there documented case studies showing the impact of exclusion screening?
Yes. Exclusion Screening provides a case study on OIG exclusions, detailing a False Claims Act judgment involving a Texas-based laboratory services company submitting false claims. The case highlights compliance challenges and the importance of thorough exclusion screening. For Nevada, recent OIG settlements show penalties ranging from ,593 to 3,992 for employing excluded individuals. Note: Additional case studies are available upon request. Read the case study.
Which industries are represented in Exclusion Screening's case studies?
The laboratory services industry is represented in Exclusion Screening's published case studies. The Texas-based laboratory services company case illustrates the compliance risks and penalties associated with exclusion screening failures. Note: For information on other industries, contact Exclusion Screening directly. Case study link.
State Medicaid Exclusion Lists & Cross-State Implications
Which states do not maintain a separate Medicaid exclusion list?
The seven states that do not maintain a separate Medicaid exclusion list are New Mexico, Virginia, Oklahoma, Rhode Island, South Dakota, Utah, and Wisconsin. These states typically treat the OIG’s List of Excluded Individuals and Entities (LEIE) as their primary list. Note: Screening requirements may differ; consult state guidelines for specifics. State exclusion database info.
Company Background & Expertise
Who founded Exclusion Screening, and what is their expertise?
Exclusion Screening, LLC was founded by nationally recognized former Federal prosecutors Robert Liles and Paul Weidenfeld, who have over 70 years of combined experience in healthcare and compliance law. The company was created to address complex compliance challenges faced by healthcare providers. Note: For detailed founder bios, visit the About Us page. About Us.
What is Exclusion Screening's mission and vision?
Exclusion Screening aims to be a national leader in exclusionary screening, providing competitively priced services accessible to organizations of all sizes. Its mission is to simplify compliance processes, mitigate legal risks, and support healthcare providers in focusing on their core operations. Note: Mission and vision may evolve; check the About Us page for updates. Mission & Vision.
New ReportScreening Failures & Their Financial Fallout — $26M in penalties and how to avoid them. Download the report →
The state of Nevada maintains the Nevada Medicaid Provider Sanctions/Exclusions — a separate Medicaid exclusion list providers must screen alongside the federal OIG LEIE and GSA/SAM. Hiring or contracting with anyone on these lists creates federal penalty exposure, even when the hire was unintentional.
Each settlement below started with one missed exclusion check. All were preventable. Don’t let your organization become the next example.
November 2023 · Nevada · Home health
$263,992 — A home health agency settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →
August 2022 · Nevada · Hospital
$250,464 — A hospital settled with OIG for employing an excluded individual (self-disclosed). Read the OIG settlement →
August 2022 · Nevada · Healthcare services
$33,855 — A healthcare organization settled with OIG for employing an excluded individual. Read the OIG settlement →
May 2021 · Nevada · Private practice
$13,526 — A medical practice settled with OIG for employing an excluded individual. Read the OIG settlement →
April 2021 · Nevada · Medical center
$10,593 — A hospital settled with OIG for employing an excluded individual. Read the OIG settlement →
The pattern is clear: Organizations of all types and sizes can be penalized for hiring excluded people or vendors. The only reliable defense is screening every employee and contractor against every exclusion list, monthly. We make that easy for you.
Is the Nevada Medicaid Provider Sanctions/Exclusions the same as the OIG LEIE?
No. The OIG LEIE is the federal exclusion list covering Medicare, Medicaid, and all federal health programs. The Nevada Medicaid Provider Sanctions/Exclusions is separate and covers providers excluded or terminated from Nevada Medicaid specifically. Providers must screen both, along with GSA/SAM.
How often do I need to screen against the Nevada Medicaid Provider Sanctions/Exclusions?
Monthly, on hire and every month thereafter. CMS State Medicaid Director Letters #08-003 and #09-001 require monthly screening of every employee, contractor, and vendor that contributes to a claim — including billers, coders, and managing employees.
Do I need to screen the Nevada list if I’m not located in Nevada?
Yes — if you bill Nevada Medicaid or employ Nevada-licensed staff, the screening obligation applies. An exclusion in one state can also trigger sanctions in others under Section 6501 of the Affordable Care Act.
Federal penalties & cross-state implications
The OIG can impose civil monetary penalties of up to $24,947 per item or service that an excluded individual contributed to. Penalties stack quickly: a single excluded employee submitting claims over several months can produce six- or seven-figure exposure. Self-disclosure reduces but does not eliminate the penalty — recent settlements show organizations paying $100K-$3M+ even after voluntary reporting.
CMS requires monthly screening of employees, contractors, vendors, and any party who contributes to a claim — including billers, coders, and managing employees. Screening is required on hire and monthly thereafter (CMS State Medicaid Director Letters #08-003 and #09-001).
An exclusion in one state can trigger sanctions in others under Section 6501 of the Affordable Care Act. Providers should screen against the OIG LEIE, GSA/SAM, and every state Medicaid exclusion list — not just their home state.
