I. SAM Exclusion Search
We talk fairly infrequently about the General Service’s Administration’s System for Award Management (GSA-SAM) and about SAM Exclusion Search and thought it was time to address that lapse in information!
We know that the Office of the Inspector General has authority to exclude individuals under Section 1128 of the Social Security Act. It is also true that many individuals who appear on the SAM were originally listed on the Excluded Parties List System (EPLS). In addition, the SAM includes information from the Central Contractor Registration System (CCR) and the Online Representations and Certifications Application (ORCA). Now that these lists have merged, we wondered where the SAM was getting its updated exclusion information from.
II. The Agencies Reporting Exclusions to the GSA-SAM
If you have reviewed the SAM, you may have noticed that different agencies are listed along with excluded individuals. As of April 21, 2015, 68 federal agencies were reporting exclusions to SAM including the Department of Health and Human Services (HHS), the Department of Justice (DOJ), Veteran’s Affairs (VA), and the Department of Agriculture (USDA).
One of our favorite activities is getting into the weeds of an exclusion database, so our experts took a closer look at the agencies that were reporting to SAM. We discovered that over half of the total exclusions reported to SAM come from HHS. This was expected because we often find that if a name matches a person on the LEIE it also matches a person on the SAM. The next largest contributors were: the Office of Personnel Management (OPM) (26.6%); the Department of the Treasury Office of Foreign Assets Control (TREAS-OFAC) (6.2%); the Department of Justice (DOJ) (5.2%); and the Department of Agriculture Office of Food and Nutrition Services (USA-FNS) (3.1%).
Because OPM is the next largest reporting agency, we looked into who is excluded under its authority. OPM is also excludes health care providers. Specifically, it is debars them from participation in the Federal Employees Health Benefits Program (FEHBP). This means that 77.4% of the persons excluded on the SAM are excluded from participating from some health care industry component.
III. Final Thoughts
This discovery supports our belief that it is critical to screen the SAM in addition to the LEIE. OPM excludes from FEHBP individuals who have lost a professional license, been convicted of a crime related to the delivery of or payment for health care services, violated provisions of a Federal program, or been debarred by another Federal agency. These reasons mirror some of the reasons individual and entities are excluded from participation in the Federal health care programs by OIG and State Medicaid offices. It is likely that individuals excluded by OPM will also be excluded by the OIG, but there is no way to know how often information passes between these agencies or between licensing boards and the agencies.
In our opinion, best practices include screening the SAM and the LEIE monthly, in addition to all available state lists, to ensure that your office is protected and potentially knows about an excluded individual before the OIG. Exclusion Screening, LLCSM conducts a comprehensive search of all available databases each month for its clients. For a free consultation, please call 1-800-294-0952 or fill out our assessment of needs and costs.
Ashley Hudson, Associate Attorney at Liles Parker, LLP and former Chief Operating Officer for Exclusion Screening, LLC, is the author of this article. Contact the exclusion experts at Exclusion Screening, LLCSM today for a free consultation by calling 1-800-294-0952 or online.