CMS open payments | OIG exclusion list | Monthly OIG screen

In the world of healthcare and business, trust is everything. When a patient visits a doctor, they want to know that the medicine being prescribed is the best choice for their health, not just the brand that paid the doctor a consulting fee. To build this trust and ensure transparency, the United States government created a program known as CMS Open Payments . While the term might sound technical, the concept is actually quite simple, and it impacts doctors, hospitals, and the businesses that work with them. CMS Open Payments program is an initiative launched by the Centers for Medicare & Medicaid Services (CMS) that aims to provide transparency regarding financial transactions between pharmaceutical companies or medical device manufacturers and physicians or teaching hospitals. Open Payments is often referred to as a "sunshine" law because it serves to illuminate the financial exchanges that occur between healthcare providers and industry. If a physician receives a payme...

If you work in the US healthcare industry, you know that patient safety comes first. However, running a medical practice, hospital, or healthcare service isn't just about treating patients; it is also about following the rules set by the government. One of the most critical rules involves knowing exactly who you are hiring and who you are doing business with. This brings us to some very important terms: OIG check , OIG exclusion, and vendor screening. While these might sound like complicated legal terms, they are actually quite simple concepts that keep your business safe and your patients protected. What exactly is the "OIG Exclusion List"? The "OIG" refers to the Office of Inspector General, an agency within the U.S. Department of Health and Human Services (HHS). The OIG's mission is to combat healthcare fraud and abuse in government programs such as Medicare or Medicaid. As part of the OIG's effort to fulfill its mission, it maintains a list of indivi...

Compliance with the law is a must for every healthcare provider. The Exclusions List OIG is one of the best compliance tools available. For hospital administrators, doctors, and staffing agencies alike, it is important to know what constitutes OIG exclusion in order to protect your business from large monetary fines and legal repercussions. What Is the OIG Exclusions List? The Exclusions list is also referred to as the List of Excluded Individuals and Entities (LEIE). It is maintained by the U.S. Department of Health and Human Services; it contains the names of individuals as well as entities who have been excluded from participation in federally funded healthcare programs. This includes Open Federal Health Care programs, such as Medicare and Medicaid. An individual or entity may be placed on the OIG exclusion list for a variety of reasons, including fraud or abuse of patients, problems with licenses, or other types of violations that threaten the integrity of federal healthcare prog...

There are many concerns that any healthcare organization has to face; patient care, staffing and billing to name a few. However, there is one thing that will cost you a fortune if not taken care of, it could destroy your company's reputation as well; the process of checking all of your new hires or those who you conduct business with. This type of check is referred to as sanctions checks or exclusion screening. Although this may sound heavy and legal in connotation, the concept itself is really quite simple and can be thought of the same way you think of a "No Fly List."  This guide will provide everything you need to know regarding these types of screening processes including, what they are and why they are important, as well as how to successfully conduct them without added stress to yourself or your organization. What is Exclusion Screening? At the national level, the Office of Inspector General (OIG) keeps records on individuals and entities that can't participa...