The Office of Inspector General (OIG) in the Department of Health and Human Services (HHS) prohibits payment from Medicare and Medicaid to excluded providers and levies hefty fines and monetary penalties upon healthcare providers for non-compliance. As a best practice, the OIG recommends monthly screening of all employees, contractors, referring physicians, and vendors against the federal List of Excluded Individuals and Entities (LEIE) and all state Medicaid registries to identify any excluded individuals or entities currently barred from participating in Medicare and Medicaid.
Healthcare providers who fail to conduct on-going monthly screenings are deemed to have “known or should have known”, of the excluded party’s barred status and are subject to fines, penalties, and even exclusion from Medicare and Medicaid if they employ or do business with any excluded individuals or entities.
ExclusionALERT™ provides much needed peace of mind for our clients offering 100% guaranteed OIG/CMS compliance with all federally-mandated exclusion search requirements backed up by our exclusive SANCTION SHIELD™ liability protection against fines and monetary penalties!
ExclusionALERT™ conducts comprehensive, real-time monthly screening of all employees, contractors, referring physicians and vendors, as mandated by the OIG. Our software uses state-of-the-art algorithms to thoroughly search all applicable federal (LEIE) and state exclusion and sanction databases, to verify potential matches to your company’s list of employees, contractors, referring physicians and vendors.
Once potential matches have been identified, each one is personally investigated by our team of experienced investigation professionals who will positively identify any currently sanctioned individual or entity you are employing or with whom you are doing business.
The Center for Medicare and Medicaid Studies (CMS) requires Medicare contractors to conduct monthly reviews of state licensing board actions.
As a participating provider with Medicare and/or Medicaid, payments made by you to any vendor currently excluded from participation in Medicare and Medicaid is prohibited.