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OIG Exclusion Monitoring with SanctionCheck

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Automatically check all relevant databases and individuals on one unified platform.
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Eliminate time spent overseeing the process of manual screeners or checking behind another vendor doing the screening.

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A reference for compliance leaders to improve their screening practices

What is the OIG LEIE List?

The United States’ Office of Inspector General was established in 1976 to assess and prevent incidences of fraud and abuse within the national healthcare programs. This office investigates claims of Medicare and Medicaid fraud — and if there’s evidence of wrongdoing, the individuals involved end up on the LEIE list.

The OIG LEIE list includes healthcare workers from around the country, but 37 states also have their own lists (which you can screen for additional diligence). Individuals who appear on the LEIE list have been found guilty of any number of wrongdoings, including:

  • Medicare or Medicaid fraud
  • Patient abuse or neglect
  • License revocation
  • Healthcare-related fraud, theft, or other financial misconduct
  • Unlawful manufacture, distribution, prescription, or dispensing of controlled substances

If a medical professional appears on the LEIE list, his or her services cannot be covered by Medicare, Medicaid, or any other government-funded healthcare program.

The OIG updates their list daily, and it is possible for individuals to be removed from the list after a certain period of time. Therefore, healthcare facilities must be vigilant in screening their employees to make sure their staff is in compliance with the OIG.

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How Often You Should Perform an Exclusion Check?

The first time you should perform an exclusion check on an employee is during the hiring process. Medical professionals should not appear on the LEIE at the time of their hiring — and hiring someone on the LEIE can result in significant monetary penalties. Therefore, an LEIE screening should always be part of the hiring process.

Even after you’ve hired a healthcare worker, it is your duty to continually screen your staff against the LEIE. The OIG suggests checking the list at least once a month, as names are constantly being added or removed. Monthly screening can guarantee that your staff is in compliance and that your facility can continue to serve Medicaid, Medicare, and other government healthcare beneficiaries.

The Importance Of Screening Vendors
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How Often Should You Check the OIG Exclusion List?

The American healthcare system relies heavily on government-funded programs like Medicare and Medicaid. About 44 million Americans are enrolled in Medicare, and Medicaid provides insurance for around 75 million people (many of them children). With this in mind, hospitals and other medical offices must make sure that their employees are in good standing with the U.S. Office of Inspector General (OIG). One way to do this is to screen employees against the OIG’s List of Excluded Individuals and Entities (LEIE) at least once a month.