According to the experts, OIG screening and checks should be done at least once a month. It ensures that your staff and vendors are not present on the LEIE (List of Excluded Individuals/Entities). This list is maintained and regularly updated by the Office of the Inspector General (OIG), an independent organization. They have the authority to add individuals and entities to the LEIE based on financial fraud, federal fraud, patient abuse, and other serious charges. Working with individuals or entities present on the exclusions list OIG puts your organization at severe financial and reputational risk.
Now, the major problem with the screening process is that the OIG regularly updates its exclusion list. Therefore, it is possible that individuals/entities who were not on the list earlier might be present on the latest list. This makes irregular or one-time OIG background checks quite unreliable, which can pose a legal problem for the organization. An effective way to address this situation is to conduct regular monthly OIG screenings and background checks. As a result, you will avoid working with OIG excluded individuals and entities.
The Importance of Regular OIG Screening and Checks in the Healthcare Sector
Regular OIG checks and screening process give you complete surety that you are not working with an excluded entity. With the help of regular checks against the latest exclusions list OIG, the possibility of inconsistency in the screening process reduces significantly. This proves to be an excellent help for bigger healthcare organizations with hundreds of staff members and service providers. The importance of regular verification is summarized in the following points:
1. Patient Safety
For a healthcare organization, patient safety is, and should be, the first priority. Hiring excluded individuals or using the services of an excluded vendor poses a significant risk to the patient’s safety. One of the reasons for OIG exclusion is patient abuse. Working or hiring someone with a history of patient abuse puts the patient’s safety in danger. Regular OIG checks will help you work with well-qualified staff who have no criminal background.
2. Removing Inconsistency
A healthcare organization can have hundreds or thousands of staff members, including doctors, nurses, cleaning staff, and many others. Imagine working with such a large database and handling various details of hundreds and thousands of employees. The chances of data inconsistency and an inaccurate screening process are not low. However, when you screen your employees and staff members at regular intervals, it removes inconsistencies from the data. It also ensures that all the staff members are screened against the latest exclusions list OIG.
3. Helps in the Hiring Process
This is another overlooked function of OIG screening and background checks. Regular screening and checks help streamline the hiring process in the healthcare sector. Here, the potential employee is screened before they are hired. As a result, you can filter out individuals who are excluded by OIG. It can save your time and protect you from future risks.
4. Improving the Quality of Services
Staff members and service providers in the healthcare organization play a crucial part in enhancing the organization’s services. When you screen your potential and current employees, it prevents you from working with employees with a criminal background. Additionally, it enables you to hire staff members who are licensed professionals and understand their responsibilities.
Severe Consequences of Working With OIG Excluded Individuals and Vendors
Working with either an OIG excluded individual or a service provider can harm healthcare organizations in multiple ways. While financial and reputational loss are the primary risks, there can be other severe consequences. You should not work with an excluded party for the following reasons:
1. Financial Penalties and Fines
Any healthcare organization that works with excluded parties, whether knowingly or unknowingly, can face financial penalties. According to the official website, the organization can face CMPs up to $10,000 for each federal service or item used by the excluded party. Depending on the severity of the case, the healthcare organization may face substantial financial penalties in addition to the CMPs.
2. Removal of Federal Funds
The immediate effect of being added to LEIE (List of Excluded Individuals/Entities) is the removal of all kinds of federal funds. The excluded party will not receive any amount of federal funds or services from Medicare, Medicaid, or any other state-funded healthcare program. Therefore, the healthcare organization might also lose federal funds and services by working with an OIG excluded individual.
3. Losing Reputation
Excluded parties are involved in severe criminal activities and financial fraud. When a healthcare organization’s name is associated with an excluded party, it severely damages its reputation. As a result, people lose trust in the organization’s services. In the healthcare industry, repairing a damaged reputation can prove to be quite challenging as people do not easily trust when it comes to their health.
Why are Individuals or Entities Added to the Exclusion List by OIG?
Now that we have discussed the risks associated with hiring excluded individuals or entities, let’s examine the reasons behind these risks. Working with parties from the exclusions list OIG is dangerous because of the grounds and reasons for exclusion. OIG, or the Office of the Inspector General, excludes individuals and entities from participating in federal healthcare programs based on the following:
- Involvement or conviction in federal fraud, including Medicare, Medicaid, or any other state-funded healthcare programs
- Any other offence that includes state-funded items and services
- Illegal manufacturing, distributing, or prescribing of controlled substances
- Abusing patients and neglecting their duties as medical professionals
- The individual or service can be excluded if their license is revoked due to unprofessional behaviour
These are some of the prominent reasons; however, there can be other possible reasons for the exclusion. As you can see, the charges are quite severe, and there is no way that OIG excluded individuals and entities are fit to handle patients or perform treatments. That is why experts emphasize the importance of regular exclusion screening and background checks.
How Venops Utilizes Advanced Software Tools for Regular Screening?
When it comes to regular OIG screening and background checks, there are no shortcuts. As a healthcare organization, you will have to screen every single staff member and service provider. All this is necessary to perform an accurate OIG check and verification. However, regular screening on your own is time-consuming and expensive. Venops, on the other hand, optimizes the screening process with automation tools under the supervision of our experts. As a result, we help you save your precious working hours. Additionally, you can focus on your core operations while we handle the complex screening process.
At Venops, we optimize screening services by leveraging our years of experience and utilizing modern automation tools. We will help you perform quick and accurate monthly screening to ensure 100% legal compliance. Our services include monthly screening, daily screening, staff screening, vendor screening, and others. And what sets us apart is our transparent pricing. You will get all the mentioned high-quality services at the right price.
Wrapping It Up!
OIG exclusion screening is an essential part of the background verification process in the healthcare sector. Screening your staff members and service providers against the exclusions list OIG helps you avoid financial and reputational risk. However, the screening and checks are not a one-time process. The OIG updates its lists of excluded individuals/entities. Therefore, you must screen your staff members and service providers against the latest OIG exclusion list. Experts recommend performing the screening process at least once a month to ensure that you are not working with any excluded individuals or entities.
If you are looking for trusted screening and compliance services, Contact Us! Our experts will provide you with personalized and optimized OIG screening solutions.
