Exclusion can be caused by convictions for healthcare program-related fraud and abuse, including patient abuse, as well as felony convictions for controlled substances. The Office of Inspector General (OIG) of the Department of Health & Human Services has the authority to exclude individuals and entities. For a list of mandatory and permissive exclusions, please see [...]
The letter means that you are a Vendor organization that provides services to health care providers or other organizations that receive federal/state medical assistance funding (e.g., Medicaid). Federal and state regulations require healthcare providers to notify you of your requirement to conduct sanction screening to determine if your entity and any of your employees are [...]
OIG Compliance NOW provides comprehensive screening service for all types of individuals and entities, including employees, physicians, referring physicians, volunteers, and vendors/contractors (entity names as well as employees). We would support health care institutions in providing all individuals and entities with a clear and conspicuous disclosure, in writing, that the OIG Sanction Report will be [...]
Turnaround time for list screening is 48 hours; validation activities will require more time and will depend on resource availability at federal and state program integrity unit offices.
Any client with validated exclusions will first be contacted by telephone prior to the generation of the monthly report. When an association match is found, an OIG Compliance NOW investigator takes that record and verifies that the employee or vendor is sanctioned and/or excluded. After all of the association matches have been investigated and verified, [...]
We are prepared to offer clients a comprehensive compliance solution for sanction screening which includes a sanction screening checklist, quarterly updates of new requirements/regulations, and an annual review of the program to encourage the development of a long-term, “best practice” compliance program. We stay connected to various federal, state and professional organizations to stay alerted [...]
Our comprehensive screening process effectively checks for sanctions of entities including all offices and branches in any part of the United States.
Our standard procedure is to report all active exclusions that appear in our monthly search results. However, using our unique and proprietary OIG Investigations tracking system, we are able to automatically identify individuals that were investigated in previous months and list those individuals as “previously identified and reported to client”. In terms of “clearing” excluded [...]
Part of our validation process includes obtaining documentation from local, state and federal agencies regarding the nature of the exclusion. We then share this documentation with the health care institution as part of our master validation report.
Results are ALWAYS VALIDATED before any communication back to the health care institution. Names of excluded individuals and entities are confirmed to be accurate through a manual investigative process that involves verbal communication with local, state and federal agencies, as required.