Showing Posts In "Healthcare Screening, Credentialing & Exclusion Screening" Category
The Office of Inspector General’s List of Excluded Individuals and Entities (OIG-LEIE) is a great source for hospitals, but making this the only source could lead to missing current and previous sanctions. Ongoing monitoring can allow hospitals to obtain real-time sanction and exclusion updates, as well as provide a glimpse into the history of those […]
This white paper is designed to provide the latest information to medical HR and compliance professionals; either as a “refresher” for what’s already known, or a source for updated rules, regulations, and processes.
– The OIG itself
– Penalties for Violation(s)
– The Permanence of Exclusions
– Types of Fraud & Abuse
– Plus a lot […]
The end of the year is the perfect time to evaluate current compliance programs that use effective processes and procedures to define, detect and prevent state and federal violations in healthcare, including patient care, physician license verification, billing, reimbursement, HIPAA privacy, and security. Allowing an excluded provider to practice can lead to severe consequences for […]
Individuals and entities can be excluded from receiving funding from federal healthcare programs and the Office of Inspector General (OIG) maintains a list in an online searchable database. Those who hire someone who is on the list can be subject to civil monetary penalties (CMP). Organizations are still on the hook if an individual is […]
Background screening is a necessary part of the hiring process, but it can be complicated and confusing in the healthcare industry. There are several myths surrounding this important process, including that conducting an OIG/GSA check meets CMS Requirements for sanctions and exclusions screening. Many also believe that doing an enhanced nationwide search, or searching the […]
Sanction and exclusion monitoring are part of a vital areas of compliance in the healthcare hiring space. A healthcare sanction, or an administrative action taken against an individual, an individual’s professional license, or an entity, involves serious consequences, such as exclusion that prohibits the sanctioned individual or entity from providing federally funded healthcare services or […]
As the COVID-19 pandemic has demonstrated, the service that healthcare professionals offer to United States citizens is crucial to a thriving American society. Organizations that employ workers in this sector should perform their due diligence to ensure that each of their providers/practitioners is properly licensed, have a clean history with their licensing board, and are […]
Every healthcare organization has its own unique background screening challenges and needs, impacting its ability to hire top talent while remaining compliant with regulations. What background screening obstacles are you running into?
Sterling’s Healthcare and Life Sciences division has compiled a list of the five most common monitoring and background screening challenges that we’re seeing health […]
Verifying a provider’s credentials can be a time-consuming process, but it is essential to confirm a provider’s education, professional license and certifications, medical training, work history, references and more. Rigorous credentialing allows a healthcare facility to remain compliant with regulatory bodies, such as the National Committee for Quality Assurance. Credentialing should be an ongoing process, […]
In December 2020, the Consolidated Appropriations Act of 2021 (H.R. 133) was put into place, requiring group health plans and health insurance insurers to improve the verification and refresh process of their provider directory systems. But most health plans were unprepared to meet the requirements that were due by Jan. 1, 2022, such as verifying […]
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