Showing Posts In "Healthcare Screening, Credentialing & Exclusion Screening" Category





DAB Decisions Highlight Importance of Regular Background Screenings and Exclusion Checks for All Employees and Managing Individuals

In a recent decision in Ambulife Ambulance, Inc., it was upheld that reliance on past owners’ disclosures does not negate a provider/supplier’s duty to accurately report any past offenses and managing employee status. In a separate case, Esohe Agbonkpolor, the decision reiterates that entering into a plea deal may be considered a conviction and, thus, […]


What is a Medical Sanction?

The U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) requires a healthcare sanction screening that is checked against the List of Excluded Individuals/Entities (LEIE) for individuals or entities who have participated in the following activities: Medicare and Medicaid fraud; patient abuse or neglect; felony convictions; financial fraud; and illegal manufacture, […]


What Healthcare Employers Need to Know About New Drug Testing Laws in 2020

The drug screening industry continues to change and with at least 33 states allowing medical use of marijuana and 11 of those states allowing recreational use, new laws can create complications within the healthcare field. The most common pre-employment screening identifies five substances, but many healthcare employers often use a more expansive 10-Panel Drug Screen. […]


CMS Preclusion List FAQs

The Centers for Medicare and Medicaid (CMS) Preclusion List is a record of providers and prescribers who are precluded from receiving payment for Medicare Advantage (MA) items and services or Part D drugs furnished or prescribed to Medicare beneficiaries. The List was found under a Federal Register Rules and Regulations update to be necessary to: […]


Onboarding Process for Physicians and Nurses

May 21, 2020 Hiring a new practitioner is a complex process for many health care entities. A clear onboarding process can make the transition easier for a physician or nurse signing on as a new provider. Every provider should have a clear idea of what steps need to be followed during their onboarding process. A […]


What are the Types OIG Exclusions?

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG), which maintains a list of all excluded individuals and entities, can prevent those who have committed health care fraud or other serious crimes from receiving federal funds through Social Security, Medicare, and state Medicaid programs. The List of Excluded Individuals/Entities (LEIE) […]


Understanding California Exclusion Screening Requirements

Two main databases, the List of Excluded Individuals/Entities (LEIE) – managed by the Office of the Inspector General (OIG) at Health and Human Services (HHS) – and the System for Award Management offer guidance on providers, individuals, and organizations that are barred from receiving payments from the federal government for committing certain violations. Some states, […]


Screening State Medicaid Exclusion Databases

The estimated number of improper payments by Medicaid in 2019 totaled $57.36 billion. The federal government has created tools to ensure that fraudulent providers and entities known to have perpetuated abuse do not receive payments, including exclusion lists. Maintained by the Department of Health and Human Services Office of the Inspector General and the General […]


7 Things You Need to Know About the CMS Preclusion List

In 2019, the Centers for Medicare and Medicaid (CMS) published new rules for providers and plans, which included the Medicare Preclusion List, a list of providers who are precluded from receiving payment for Medicare Advantage (MA) items and services or Part D drugs furnished or prescribed to Medicare beneficiaries. Created to replace the MA and […]




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