Which exclusion lists are included in Exclusion Screening’s package?
At Exclusion Screening, LLC, we think it is critical to screen employees and vendors against OIG-LEIE, GSA-SAM, and all of the state Medicaid exclusion lists currently available.
How often is Exclusion Screening’s exclusion database updated?
OIG-LEIE updates its list monthly, while GSA-SAM and state exclusion lists vary. We automatically update our lists each month to ensure that our clients’ employees, vendors, and contractors are screened against the most up-to-date databases.
May I have multiple users?
Absolutely! Exclusion Screening, LLC recommends limiting your exclusion screening to three individuals, but, we provide additional logins depending upon your specific size and needs.
Do I need to verify my own “hits”?
Unlike other exclusion screening companies, we do all the work for you from assisting you with formulating your screening list to verifying any potential hit we discover.
How many lists may I upload for monitoring?
Here at Exclusion Screening, LLC, we believe there is more to a successful monthly exclusion screening check than uploading a list of employee names and running a search. That is why we work with our clients to make sure they have thought of every person that needs to be included on their Exclusion Screening list.
How often may I update my Exclusion Screening list?
As often as you need to! You will have access to your employee list at all times and may update it anytime at no additional charge.
Will you screen an employee if they are hired in the middle of the month?
Of course! We want to make sure new employees are screened immediately so we will screen all new hires at no additional charge.
How often should employees and vendors be screened for exclusions?
At Exclusion Screening, LLC, we, along with OIG, strongly recommend screening employees on a monthly basis.
What is the difference between the OIG-LEIE, GSA-SAM, and the state Medicaid exclusion lists?
The List of Excluded Individuals and Entities is a list of mandatory and permissive exclusion actions taken by OIG which is updated monthly. The System for Award Management (GSA-SAM) includes debarments and sanctions. The state Medicaid lists include providers who have been excluded or terminated from participating in a state’s Medicaid program, which makes them excluded from participating in any state.
Why do I need to check the OIG-LEIE, GSA-SAM, and the state Medicaid exclusion lists?
Currently, states are not required to report exclusions to OIG and there is requirement to share exclusion information between states. Therefore, the OIG-LEIE does not contain all persons excluded under State Medicaid programs and a person who is excluded in one state might and likely will not show up on another state’s exclusion list. However, under ACA section 6501, if a person is excluded in one state, then they are excluded from participating in the Federal health care programs in any state.
What is OIG’s Administrative Process for Implementing Exclusions?
OIG’s administrative process is governed by the Social Security Act’s implementing regulations.
What happens if an individual is excluded?
If an individual is excluded, then he or she may not directly or indirectly participate in the Federal health care programs. No federal payment will be made for any items or services that are furnished or provided by excluded persons.
What should I do if I receive a positive confirmation from Exclusion Screening?
We recommend ending the relationship immediately and contacting legal counsel.
What is a waiver?
Waivers are only available in certain situations, like if the excluded provider is the only physician in the area or he or she is the only person in a community who is able to offer a certain form of specialized care. Waivers must be requested by the administrator of a Federal or State health program.
When a waiver is granted payment is permitted under Medicare, Medicaid, all Federal health programs within the scope defined by the waiver.
How do I get reinstated after an exclusion period?
Excluded individuals must apply for reinstatement by sending a written request to OIG and filling out Statement and Authorization forms provided by OIG. This request may be submitted 90 days before the end of the exclusion period.