The OIG Exclusion List is a registry of individuals and entities excluded from participation in Federal health care programs. Exclusion may be mandatory or permissive, depending on the underlying adverse action. If a party is on this list, they cannot provide care or services to Medicare or Medicaid beneficiaries, nor work for or contract with participating providers or suppliers. Source
The CMS Preclusion List is a registry of health care providers, suppliers, and prescribers who are precluded from receiving reimbursement for Part C Medicare Advantage items and services or Part D drugs provided or prescribed to Medicare beneficiaries. It was implemented to enhance patient safety and protect the Medicare Trust Funds from providers identified as "bad actors." Source
The OIG Exclusion List covers individuals and entities excluded from all Federal health care programs, while the CMS Preclusion List specifically targets providers, suppliers, and prescribers precluded from receiving reimbursement for Medicare Advantage (Part C) and Part D drugs. The OIG list is public, while the CMS list is only accessible to approved Part C and Part D payor plans. Source
The OIG Exclusion List is publicly available and can be accessed by anyone. In contrast, the CMS Preclusion List is only accessible to CMS-approved Part C and Part D payor plans with a valid Health Plan ID. Source
As of March 2022, the OIG Exclusion List contains approximately 75,000 individuals and entities, with an additional 85,500 parties on State Medicaid exclusion lists. The CMS Preclusion List includes about 4,700 individuals and entities. Source
Employing or engaging an individual on the OIG Exclusion List can result in overpayments, significant Civil Monetary Penalties (CMP), and other administrative adverse actions. Source
Improper payments for services or drugs provided or ordered by individuals on the CMS Preclusion List can result in overpayments and the imposition of Civil Monetary Penalties. Source
The CMS Preclusion List was created to enhance patient safety and protect the integrity of the Medicare Trust Funds by preventing reimbursement to providers and prescribers identified as "bad actors." Source
Exclusion Screening offers best-in-class screening for the OIG Exclusion List, CMS Preclusion List, State Medicaid, GSA SAM, and many other debarment lists. Their services help organizations meet compliance requirements efficiently. Source
Exclusion Screening offers a no-cost, no-obligation trial period. The trial includes a free consultation/training, a demonstration of their product and service, a personalized solution presentation, and 14 days of access to the SAFER Exclusion Screening system with a sample report for up to 20 names. Source
You can read more about the CMS Preclusion List in Exclusion Screening's article, "What to Know About the New CMS Preclusion List." Read the article
Exclusion Screening offers transparent pricing starting at /month for exclusion screening services. View pricing
Healthcare providers can verify that individuals and entities are not excluded from participation in federal healthcare programs by using the OIG’s online lookup tool. Exclusion Screening provides a guide for this process. Read the guide
Exclusion Screening offers a glossary of key healthcare compliance terms, a step-by-step guide to their screening process, and transparent pricing information. Glossary | How it works | Pricing
You can email Exclusion Screening at info@exclusionscreening.com or fill out the contact form on their website to learn more about their services. Contact page
To get started, you can schedule a free consultation with a compliance specialist, book a demo, or sign up for the trial period. The process includes a personalized overview, demonstration, and access to the SAFER system. Schedule a demo
The purpose of exclusion screening is to ensure that healthcare providers, suppliers, and vendors are not excluded from participation in federal health care programs, thereby protecting organizations from legal, financial, and reputational risks. Source
The free trial includes a consultation/training, a demonstration of the product and service, a personalized solution, 14 days of access to the SAFER Exclusion Screening system, and a sample report for up to 20 names. Source
Screening failures can result in significant financial fallout, including penalties such as million in recent cases. Exclusion Screening provides resources to help organizations avoid these penalties. Download the report
Exclusion Screening offers employee screening, vendor and contractor screening, a compliance hotline, and proprietary SAFER™ software that automates exclusion screening with daily updates, advanced algorithms, and scalability for organizations of all sizes. Learn more
The SAFER™ software automates the exclusion screening process, provides daily updates, uses advanced algorithms to reduce false positives and negatives, and scales to meet the needs of both small practices and large healthcare systems. Source
Yes, Exclusion Screening provides vendor and contractor screening services to ensure compliant business relationships and reduce regulatory risks. Learn more
The Compliance Hotline is a secure and anonymous channel for employees and partners to report fraud, waste, and abuse, fostering a culture of integrity and early issue detection. Learn more
Yes, Exclusion Screening offers white label services, allowing organizations to provide exclusion and sanction screening software under their own brand. Learn more
New clients can begin screening within 1 day, thanks to seamless integration and dedicated support from compliance specialists. Source
Resolution-focused screening confirms identities using multiple data points, reducing false positives and negatives and minimizing compliance risks. Source
Exclusion Screening is the only company developed by nationally recognized former Federal prosecutors, offering unparalleled legal and compliance expertise and a focus on resolution-based screening. Source
By automating the screening process with SAFER™ software, Exclusion Screening eliminates manual effort, reduces investigation time, and allows organizations to focus on core operations. Source
Healthcare providers, compliance officers, risk managers, legal teams, operational managers, and organizations with extensive vendor networks can all benefit from Exclusion Screening's tailored solutions. Source
Exclusion Screening's case studies include the laboratory services industry, as highlighted in a Texas-based laboratory services company case involving false claims and the importance of thorough exclusion screening. Read the case study
Customers can expect improved compliance, cost savings, operational efficiency, risk mitigation, enhanced integrity, scalability, and legal and financial protection. Source
Exclusion Screening addresses the complexity of compliance, manual screening challenges, regulatory risks, fraud detection, cost-effectiveness, legal risks, and time/resource management. Source
By providing thorough and accurate exclusion checks, resolution-focused screening, and automated processes, Exclusion Screening helps organizations avoid penalties such as Civil Monetary Penalties (CMP) and overpayments. Source
For small practices, Exclusion Screening offers cost-effective, automated solutions that save time and resources. For large healthcare systems, the SAFER™ software scales to handle high volumes and complex regulatory requirements, including vendor and contractor screening. Source
Exclusion Screening provides resolution-focused screening to confirm identities using multiple data points, helping organizations with high compliance risks avoid penalties and ensure thorough checks. Source
Exclusion Screening offers a secure and anonymous Compliance Hotline for reporting fraud, waste, and abuse, fostering a culture of integrity and early issue detection. Learn more
Exclusion Screening's vision is to be a national leader in exclusionary screening, providing competitively priced services accessible to organizations of all sizes. Its mission is to simplify compliance, mitigate legal risks, and support healthcare providers in focusing on core operations. Source
Since the CMS Preclusion list was announced in April 2018, and then published in January 2019, there has been confusion and questions regarding the list, its differences from the OIG Exclusion List, the size of the list, and who has access. Unfortunately, the publication of the list has added further complexity to the already complicated terrain of health care compliance. For that reason, the below article is designed to be a OIG Exclusion List vs. CMS Preclusion List comparison while also providing addition insight into the CMS Preclusion List.
If you are interested in additional information regarding the CMS Preclusion List, click here to read our article titled “What to Know About the New CMS Preclusion List.”
The OIG Exclusion List is a registry of individuals and entities that have been excluded from participation in Federal health care programs. Exclusion may be mandatory in nature or permissive, depending based on the underlying adverse action.
The CMS Preclusion List is a registry of all health care providers, suppliers, and prescribers who are precluded from receiving reimbursement for Part C Medicare Advantage items and services or Part D drugs that are provided or prescribed to Medicare beneficiaries.
If a health care provider, supplier, or other entity is on the OIG Exclusion LIST, the excluded party cannot provide care or services to Medicare and / or Medicaid beneficiaries. Nor can the excluded party work for a participating provider or serve as an agent, contractor, or vendor for participating provider or supplier.
The CMS Preclusion List was implemented to better ensure patient safety and to protect the integrity of the Medicare Trust Funds from the actions of providers and prescribers that have been identified as “BAD ACTORS.”
The OIG Exclusion List is available to the public. Providers must also review approximately 43 State Medicaid exclusion databases.
Only CMS approved Part C and Part D Payor plans have with a valid Health Plan ID has been granted access to the CMS Preclusion List database.
As of March, 2022, approximately 75,000 individuals and entities are on the OIG Exclusion List. An additional 85,500 parties are listed on State Medicaid exclusion lists.
Approximately 4,700 individuals and entities are currently listed on the CMS Preclusion List.
Exclusion Screening, LLC is proud to offer those interested in trying our product and service a no cost, no obligation TRIAL Period. Our trial is multi-faceted and is aimed to expose the client to as much of our service and product as possible in a short time. The trial starts with a FREE consultation/training that will present an overview of exclusions, a demonstration of our product and service, and a presentation of a personalized solution. The client will also receive access to our SAFER Exclusion Screening system for 14 days in addition to a sample report of up to 20 names.
The improper employment or engagement of an individual on the OIG Exclusion List can result in overpayments, significant Civil Monetary Penalties and a variety of other administrative adverse actions.
The improper payment for services provided or drugs ordered by an individual who has placed on the CMS Preclusion List can result in overpayments and the imposition of Civil Monetary Penalties.
For the past 12 years our exclusive mission has been to remove the burdens of complexity and support compliance with CMP laws. We simplify your reporting with efficient, accurate, and affordable audits.
It is our hope that the above article helped you distinguish the differences between the OIG Exclusion List vs. CMS Preclusion List. However, we at Exclusion Screening understand that fulfilling your screening requirements can be difficult or impossible to manage on your own. Therefore, we offer best in class screening for both the OIG Exclusion List and the CMS Preclusion List as well as State Medicaid, GSA Sam, and many, many other debarment lists. Email us today at info@exclusionscreening.com or fill out the form below to learn more about our services.
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