3 Reasons Sanction Screening is Important for the Healthcare Industry

The healthcare industry is a vital part of society – particularly now, in the wake of a global health crisis. We rely on healthcare professionals to provide us and our loved ones with excellent care and advice. This way we can all continue to live healthy and happy lives.

Of course, the healthcare industry is only successful when the people working in it are knowledgeable, reputable, and safe. How do you know if your employees fit the bill? With regular sanction screenings.

What is Sanction Screening?

Sanction screening is a type of evaluation required of all healthcare organizations who accept government payments, including vendors, contractors, new hires, physicians, and volunteers. This screening determines whether any individual working in the healthcare industry is currently excluded from participating in U.S. federal healthcare programs.

To conduct a sanction screen, a healthcare provider should collect the following information from their employees:

• First, middle, and last names
• Social Security Number
• Date of birth
• Provider license number

Next, the provider will screen this information against the names listed in the List of Excluded Individuals and Entities (LEIE). This list is compiled by the Department of Health and Human Services Office of Inspector General (OIG), and it contains the names of individuals who are (or have been) involved in some form of illegal or unethical misconduct in the healthcare industry.

Why Sanction Screening Matters

If an individual’s name appears on the LEIE, they are not legally able to work in the healthcare industry. Additionally, any organization that hires someone listed on the LEIE may be subject to monetary penalties. Therefore, the OIG advises healthcare providers to conduct sanction screenings often.

While there is no official rule for the frequency of screenings, it’s recommended to do a sanction screening each month. The LEIE is updated monthly, so regular screenings will ensure none of your staff appears on the list. Read about the most common sanction screening mistakes healthcare organizations make and how to avoid these shortcomings here.

Fines and penalties aren’t the only reason to complete regular sanction screenings. These screenings and the LEIE are designed to protect both the healthcare industry and anyone who interacts with it. Here are a few reasons why sanction screening is important:

Minimizes Compliance Risks

Individuals who appear on the LEIE have been involved in all manner of unethical behavior, including fraud and abuse. As a result, the federal government bans them from working in the healthcare field nationwide – and sets compliance rules against hiring them. Screening people during the pre-hiring process, as well as regularly throughout the year, is the best way to make sure your institution meets those compliance requirements.

As we’ve already mentioned, hiring someone who is on the LEIE (or continuing to employ someone after they appear on the list) can result in penalties for healthcare providers. These penalties can be severe; for example, in July 2020 a health center in Texas was ordered to pay over $140,000 because they employed someone who was listed on the LEIE!

However, monetary losses are not all you’re risking when you fail to conduct sanction screenings. By taking the time to ensure that your staff has not been involved in any fraud, patient abuse, or other unethical behavior, you ultimately protect your organization from these kinds of unsavory situations. Regular screenings keep everyone honest, which results in better care for your patients and a better reputation for your facility.

Keeps Staff Safe

There are a variety of reasons why a healthcare professional might appear on the LEIE. In fact, there are two types of exclusions: 1) mandatory exclusions, which bar the individual from all federal healthcare programs; and 2) permissive exclusions, which are at the discretion of the OIG and tend to bar the individual for a shorter period of time.

Mandatory exclusions include:

• Medicare or Medicaid fraud
• Felony convictions for fraud, theft, or financial misconduct
• Felony conviction for distributing or prescribing controlled substances

Permissive exclusions include:

• Misdemeanor convictions for health care fraud
• Suspension, revocation, or surrender of a medical license due to professional incompetence
• Engaging in unlawful kickbacks

Conducting screenings helps you eliminate those potential staffers (or current staffers) who might engage in unlawful activity – or engage in unsafe practices (in the case of permissive exclusions due to suspended licenses). If all your staff members are cleared by the OIG, you can feel confident that everyone will be safe on the job.

Keeps Patients Safe

Finally, we’ve reached the most important reason to comply with the OIG and conduct sanction screenings: patient safety. When people visit your hospital, clinic, or other medical facility, they are putting their trust in your professional care. These individuals deserve to encounter caring staff who want to help them become healthier and happier – not individuals looking to defraud their insurance.

In our healthcare system, the professionals in medical offices are responsible for a patient’s physical health – but they can also play a major role in their financial situation. Instances of fraud or theft can have real ramifications for these patients. Therefore, conducting regular sanction screenings is essential. Eliminating bad actors from the healthcare industry is the best way to protect the people who come into your office from these types of risks.

Outsource Sanction Screening

Although sanction screening is an essential part of the healthcare industry, it can be incredibly challenging for HR managers and other professionals. After all, there can be thousands of employees in any one facility! Collecting all their names and personal information – and then cross-referencing those names with a national database – can be time consuming, and mistakes can easily occur.

Thankfully, there are many third-party tools available that you can use to streamline the sanction screening process. These software programs and automated systems will make sanction screening quicker and more accurate, so you can get back to focusing on your patients.

At ComplianceLine, we want to make sanction screening easy, fast, and effective for your office. Our software ensures compliance with OIG, as well as other organizations like HHS, HIPAA, and BAA. You can eliminate risk, protect patients, and manage multiple facilities all from one centralized system! Contact us today to learn more about how this program can help your healthcare staff.