Best Practices for Healthcare OIG Exclusion Screening Monitoring

The U.S. Office of the Inspector General (OIG) can exclude certain people or organizations from providing services under federally funded healthcare programs. It is important for healthcare providers to be aware of the exclusions because arranging or contracting with excluded individuals can be subject to civil monetary penalties. Exclusions can happen for several reasons, including conviction for Medicare or Medicaid fraud, conviction for other fraud offenses that involve federal or state healthcare programs, and patient abuse or neglect, among others. Some reasons lead to mandatory exclusions, while others can be made at the discretion of the OIG. Once excluded, an individual or entity can receive no payment for services under any federal healthcare programs. Best practices include: referring to the List of Excluded Individuals/Entities (LEIE), conducting monthly exclusion screening, staying up to date on state Medicaid exclusion lists, establishing collaboration between departments, and using a comprehensive exclusion screening solution to drive efficiency.

 

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Post By Ken Shafton (2,396 Posts)