Exclusion Basics

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 their programs…

Why is it Necessary to Screen Against the NPPES and its NPI Registry Database?

 We are sometimes asked, “Does Exclusion Screening perform NPI1 screening services?”  That’s a great question. The answer is “YES.” As discussed below,…

A Provider’s Guide to OIG Exclusions

A Provider’s Guide to OIG Exclusions: Federal Exclusion Regulations and Enforcement Authorities, and How Providers Can Avoid Risk with Proper Exclusion…

What is an OIG Exclusion?

OIG Exclusions are powerful enforcement sanctions that bar an individual or entity from any participation in Federal and State health…

What is the NPDB?

I. What is the NPDB The National Practitioner Data Bank (NPDB) was created as part of the Health Care Quality…

What is the Length of A Mandatory Exclusion?

The Department of Health and Human Services (HHS), Office of Inspector General (OIG) is responsible for overseeing the financial and…

What is the Scope of a Mandatory Exclusion Brought Under Section 1128(a)(4) of the Social Security Act (Act)?

The Department of Health and Human Services (HHS), Office of Inspector General (OIG) exercises both mandatory and permissive exclusion authority…

Which Federal & State Exclusion Lists Should Be Screened?

The complex web of regulation encompassing government health care dollars is a lot to take on. With 41 state exclusion…

A Provider’s Guide to Medicaid Exclusions in Texas: Exclusion Screening Requirements and Best Practices for Compliance

(December 17, 2018):   Texas Medicaid Exclusions will prevent the Texas Medicaid Program from paying for any item or service furnished…

The New “Seventh Element” of Compliance: Screening and Evaluating Employee Suitability!

The recently issued Resource Guide for Measuring Compliance Program Effectiveness, reconfigures the traditional formulation of the “Seven Elements of an…