What is
OIG exclusion list?
The OIG (Office of Inspector General)
List offers details to the health care industry and also to the public
regarding individuals and entities that are excluded from participating in any
Medicare or any other Federal Health Care programs. OIG Exclusion SearchSoftware is being used by many
reputed organizations to make sure that they are dealing with right source.
What are
the different types of OIG exclusions?
Broadly speaking, there are two types
of OIG exclusions:
- Mandatory Exclusions – are put
as penalties for health care fraud or crime or illegal distribution of
controlled substances.
- Permissive Exclusions
– are meted out as penalties under sixteen authorities and is put due to
loss of state license to practice or failure to repay student loans or any
other misdemeanors.
How often
should employers screen excluded individuals?
Screening for excluded
individuals is a must for any healthcare provider as it may result in monetary
penalties, payment bans, and the company can be excluded as well. Seeing the importance
of this screening, it is advised that the healthcare providers conduct the OIG Exclusion List Screening as
often as possible.
It is a good practice to conduct the New York OIG ExclusionSearch on a monthly basis as the OIG updates the LEIE (List of Excluded
Individuals and Entities) on a monthly basis. Doing so will also cut the added
cost and effort of conducting screenings at random.
Apart from the LEIE, there are
various other federal and state level exclusion lists managed by different
states. It is possible that the names present in the state list are not present
in the federal list and vice versa. You must screen all the lists to avoid
monetary loss.
What
happens if an excluded person or entity submits a claim?
The following financial penalties are
applied if an excluded person or entity submits a claim:
-
He or she may be subjected to CMP of 10, 000
dollar for each claimed item or service
-
He or she may be subjected to an assessment of up
to 3 times the amount claimed.
-
He or she may be civilly liable under the False
Claims Act for presenting a fraudulent claim for payment.
Exclusion
Screening, LLC has been serving this industry for years and we help
organizations in exclusion screening with ease. We can do exclusion screening and
verification to know if any of your employee, vendor or contractor have ever
been excluded from the state exclusion database.
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