Guidelines for health care providers to screen employees, contractors and vendors monthly against LEIE exclusion list.

Requirements

“To avoid potential CMP liability, providers should check the LEIE (List of Excluded Individuals and Entities) prior to employing or contracting with persons and periodically check the LEIE to determine the exclusion status of current employees and contractors. OIG updates the LEIE monthly, so screening employees and contractors each month best minimizes potential overpayment and CMP liability. Additionally, in January 2009, CMS (Center for Medicare and Medicaid Studies) issued a State Medicaid Director Letter (SMDL) recommending that States require providers to screen all employees and contractors monthly. In 2011, CMS issued final regulations mandating states to screen all enrolled providers monthly.” OIG Special Advisory Bulletin on the Effect of Exclusion From Participation in Federal Health Care Programs (May 8, 2013) p. 15

OIG imposes large fines, monetary penalties and possible program exclusion upon providers that employ or enter into contracts with excluded persons or entities to provide items or services payable by Federal health care programs.
April 8, 2016

Items and Services that Excluded Parties May Be Furnishing Which Will Subject Their Employer or Contractor to Possible Civil Monetary Penalty (CMP) Liability
April 8, 2016

Medicare/Medicaid payments are prohibited to providers who furnish any items and services at the medical direction or on the prescription of an excluded person.
April 8, 2016

Providers are responsible to ensure that the ordering or prescribing physician is not excluded from participation in Medicare/Medicaid.
April 8, 2016

CMS Licensure Requirements for Medicare and Medicaid Providers and Suppliers
April 8, 2016

OIG recommends contractors be screened by providers or validate that the contractor is conducting proper screening on behalf of the provider to avoid liability.
April 8, 2016