CMS open payments | OIG exclusion list | Monthly OIG screen

Healthcare compliance is complicated. It's almost as if we're trying to solve a giant jigsaw puzzle where the parts are constantly changing. Two of the largest pieces of the puzzle involve staff exclusion screening and financial transparency.   First, let's take a closer look at the concepts of exclusion screening, the lists associated with screening, and the CMS open payment data to determine how they can be explained or defined in simpler terms. The Reality of Exclusion Screening Exclusion Screening is when you check to see if your employees and vendors have been excluded from working in the healthcare field through any of the Federal lists. However, to comply fully with the law, you need to check many more sources of information than just the Federal lists. You can't just check one database to make sure someone is not excluded from working in the healthcare field. You need to check the OIG Exclusions List , SAM.gov (System for Award Management) and numerous state Me...

Trust is a huge part of both operating a business and managing a healthcare facility. You have trust that your employees are performing their jobs correctly. In addition, you trust your vendors to provide high-quality products. On the other hand, if you have an unreasonable level of trust and do not screen companies to do business with, you might be surprised if you hired a contractor that was banned from your industry or a vendor with a history of stealing from their customers. The purpose of exclusion screening and vendor screening is to prevent surprises like this from happening. These concepts may sound like legal jargon, but they are actually just simple safety procedures or safety measures, such as locking your home at night. What is Exclusion Screening ?  First, let’s talk about what an exclusion screening is. In almost every industry, federal/state governments produce an ‘exclusion list’ of individuals and organizations who have been excluded (banned) from taking part in fe...

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...

Financial institutions use sanctions screening as an important tool to identify, prevent, control, and minimize the potential risks of financial crime. Companies should conduct extensive and effective  Sanction Screen  in their financial crime prevention strategies in order to identify any particular groups and organizations that could be involved in any illegal activities, such as money laundering. Why Was Screening Formed? Sanctions are a form of punishment that is often used by official bodies and governments, such as regulators, to restrict access to services. Generally, a nation's financial system dictates how it is able to move forward. Sanctions have been established to modify the conduct, discourage illegal activity, and prevent the unwanted behaviour of high-risk individuals or organizations. Recently, we have seen sanctions imposed against entire nations in the Ukraine conflict. Since the list of sanctioned entities is currently growing quicker than before, the...