Not conducting monthly exclusions monitoring poses a compliance risk and finding an “excluded individual” within your business relationships can result in fines and repayment.
We have created an infographic that covers the key points you need to be aware of.
Remember – Businesses typically owe monies back to payers when an “excluded individual" is identified!
Entities that receive Federal and State funds, such as payment for services, should, as recommended by OIG, screen the minimum two Federal databases—LEIE and SAM —at least monthly to ensure that employees, contractors and vendors are not excluded from participating in Federal health care programs. Many states have requirements to screen State Exclusion databases as well.
In one recent case, a provider was fined more than $300,000 for employing a single excluded individual. Read more...
Regardless of size, companies receiving funding from Federally funded programs can incur Civil Monetary Penalties for Exclusions violations. The OIG has authority to exclude individuals and entities, which include Nursing Facilities and Senior Living, Physicians and Hospitals, Home Health and Home Care Agencies, Hospice Agencies, Dentists and Dental groups, Therapy and Chiropractic providers, Behavioral Health, and other specialty providers.
Sign up for our LWEnSCheck™ subscription service to verify your staff and other business relationships are not Medicare, state excluded, or sanctioned individuals and entities. You can perform individual verifications as well as batch lists. State-based exclusion lists are also available.
Outsource the task to us and we'll ensure that all of your team members, vendors, and other business relationships are not Medicare, state excluded, or sanctioned individuals and entities. Contact us to discuss pricing for this option.