Employees to be screened fall into two categories: 1. those that are directly involved in the claim/order process, that are using/receiving medical assistance money, and 2. those that “causing medical assistance money to flow” to the healthcare facilities that you service. This applies to employees at any of your locations. Again, if you need further [...]

The screening requirement is based on how your vendor organization “causes Medicaid money to flow” to the healthcare facility. Some vendors are providing products, like assistive devices for IEP students, and these vendors need to screen their entity names. Others are providing specialists (individuals) to the healthcare facility that provide services. In this case, both [...]

Vendors do not need to be submitting claims to be required to screen. As a contractor to a school or hospital, your vendor organization could be “causing the Medicaid money to flow” from the federal system to the school or hospital that has notified you. This means that your organization “adds value to a claim” [...]

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 [...]