Healthcare Vendor Certification: Let the Buyer Beware

As a provider of healthcare services, you must depend on the services of many other professional organizations in order to deliver the quality of services your patients expect. And you have probably spent many years developing strong vendor relationships, especially with those vendors who are critical to your continued success.

However, did you know that if you are a provider of Medicare and/or Medicaid services, you are prohibited from paying any vendor who is currently excluded from participating in Medicare. And that extends beyond just the vendor itself. If anyone who has more than a 5% ownership in the vendor company is on the OIG exclusion list, paying that invoice would mean that you are in non-compliance with the OIG and are subject to fines, monetary penalties and even possible exclusion of your company from participating in Medicare and Medicaid!

As a provider who receives payment from Federal health care programs, the exposure risk and liability you face just by using vendors in the day-to-day operation of your business is large and the penalties are severe. Now more than ever, it is definitely a case of “let the buyer beware.” How much do you know about your business partners? The OIG puts the responsibility squarely on your shoulders.

If you receive money from Federal health care programs and use any of that money, directly or indirectly, to pay an excluded vendor, the OIG holds you responsible and liable. Their simple standard is did you know, or should you have known, that your vendor, or anyone with ownership in their company, was excluded from participation and therefore prohibited from receiving payments from you as a Medicare and/or Medicaid provider.

That’s right! An excluded provider is not just prohibited from receiving payments directly from Federal health care programs but is also excluded from receiving any payments from you if any of your money used to pay an excluded vendor has come from payments of Medicare and/or Medicaid claims.

Insure you meet all compliance requirements of health care providers from the OIG/CMS by utilizing the services of ExclusionALERT, VendorALERT and LicenseALERT. We offer 100% compliance with OIG/CMS exclusion requirements and back it up with our exclusive Sanction Shield of liability protection.

Eliminate your risk and exposure through professional monthly monitoring of your employees, referring physicians, contractors and vendors as recommended and required for compliance. We also provide license verification and monitoring of all your professionally-licensed personnel to protect you against problems related to license revocations, sanctions, and lapses.