(October 9, 2019): Should you choose to participate in the Medicare and / or Medicaid programs, you must comply with a wide variety of program integrity requirements. One obligation in particular is often missed by physician practices, home health agencies, hospices and laboratories – the “screening” of employees, contractors and agents to ensure that the… more>>
A Provider's Guide to OIG ExclusionsFederal Exclusion Regulations and Enforcement Authorities, and How Providers Can Avoid Risk with Proper Exclusion Screening--Part 1Paul S. Weidenfeld, JDThis article was originally written by Paul Weidenfeld and published by GreenBranch Publishing. This article is Part I from a 2-Part article originally published by GreenBranch Publishing on their website.Office of… more>>
OIG Semi-Annual Report to Congress Spring 2019(June 3, 2019) The Office of Inspector General (OIG) recently published its Semi-Annual Report to Congress covering from October 1, 2018 to March 31, 2019. The OIG report focuses on the enforcement actions that were brought and the exclusions that were imposed during the past reporting period in support… more>>
(May 30, 2019) In August, 2011, the State Department of Public Welfare issued a bulletin requiring providers to screen employees and contractors upon hire and monthly thereafter by the (Medicheck) Pennsylvania Exclusion List (their corresponding State exclusion/preclusion list), the HHS/OIG List of Excluded Individuals and Entities (LEIE) and the Excluded Party List (EPLS, now the… more>>
I. Medicaid Exclusion Exclusion Screening, LLC conducts monthly checks of our clients' employees, contractors, and vendors against the OIG-LEIE, GSA-SAM, and all available State Exclusion Lists. Most providers understand that they have an obligation to check their employees, contractors, and vendors against the OIG-LEIE prior to hiring and monthly thereafter. Fewer providers are aware of… more>>
(May 2, 2019) The Alabama Medicaid Program imposes significant exclusion screening requirements on its providers. Many are unaware of the extent of their exclusion screening obligations or of the severe consequences that can result from a failure to properly screen. This short summary has been prepared to help further provider awareness of the exclusion screening rules… more>>
What are the California Exclusion Screening requirements? The Medi-Cal Program will not pay for any item or service furnished directly or indirectly by individuals or entities that have been excluded or suspended from the Medi-Cal Program or that have been placed on the Office of Inspector General’s “Exclusion List. This results in a broad “suspension”… more>>
New Evidence Shows the Efficiency and Benefits of Using an Internal Compliance Hotline System(April 4, 2019): In December of 2018 a study was conducted by Kyle Wench (George Washington University) and Stephen Stubben (University of Utah) to examine the use and extent of internal whistleblowing systems within publicly traded organizations. This study was the first… more>>
There are two federal databases that list persons and entities that have been excluded from participating in federal health care programs or receiving federal contracts. Checking and verifying individuals on the OIG Exclusion List of Excluded Individuals and Entities (LEIE) and the GSA System for Award Management (SAM) should be part of any compliance exclusion screening program.… more>>
By: Cason Liles(February 12, 2019) Beginning April 1, 2019, CMS’s new Preclusion List will go into effect subsequently barring many healthcare professionals from receiving payment for Medicare Advantage (MA) items and services or Part D drugs furnished or prescribed to Medicare beneficiaries. But what is the Preclusion List? Who is on it? Why was created? Don’t worry,… more>>