Hospital systems, and other healthcare providers, are required to screen providers and all employees monthly to verify whether or not they have been placed on the OIG LEIE and other exclusion lists. The verification should happen prior to hiring, but it is also a best practice to conduct continuous monitoring on your staff for any criminal activity.
With our batch matching service, we check your applicant and employee file against the LEIE Exclusion List, the GSA-SAM Exclusion List, State Medicaid Exclusion Lists, State Medical Board Disciplinary Action files, AND our proprietary Health Care Fraud File which contains thousands of the most recent indictments and arrests in the health care space. The primary advantage of using this file is that recent indictments and convictions are included. Another advantage of using this file is that it contains physicians as well as non-physician (no NPI) individuals who have been convicted of health care fraud. This means you will be able to screen for civilians caught in pill-mill schemes, such as patient recruiters, or home health care agency personal care aids who have pleaded guilty to committing health care fraud.
We provide either a one-time batch matching service, or can set up a monthly or quarterly subscription for continuous monitoring.
The Office of the Inspector General (OIG) for the Department of Health and Human Services has the authority to exclude individuals and entities from Federally funded health care programs pursuant to section 1128 of the Social Security Act (Act) (and from Medicare and State health care programs under section 1156 of the Act) and maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (LEIE). Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties (CMP).