Do you also want to gain detailed knowledge of sanctions checks before performing OIG Screening? If yes! You are on the right platform.
Well, Sanctions checks are among the essential steps considered in healthcare, finance, and other industries. Furthermore, it ensures that you will never partner with or hire an excluded entity or individual, and that you will stand entirely for Office of Inspector General (OIG) compliance. Moreover, sanction checks are the best way to verify entities, individuals, and transactions that are not involved in terrorist activities or parties listed under sanctions lists that are maintained by OIG checks, the government, or international bodies. In this article, we will discuss why sanctions checks are crucial in the healthcare industry.
Importance of Sanction Checks in the Healthcare Industry
The following segments indicate the significance of sanction checks. Let’s go through them one by one to get precise and accurate information.
1. Preventing Financial Crimes
By recognising and preventing dealings with sanctioned individuals or entities, healthcare sanction checks play an essential role in highlighting any activity connected to or supporting the commission of illegal activities. Furthermore, these can range from minor crimes to pre-planned crimes, such as trafficking humans, drugs, or weapons, in many cases.
2. Exclusion from Federal Programs
Working with sanctioned individuals or service providers subjects the healthcare organization to exclusion from federal financial support. Organizations found employing sanctioned or excluded individuals, whether knowingly or unknowingly, are prohibited from participating in federally funded programs. This also included potential CMPs and financial fines, as well as license suspension in the worst case.
3. Protecting Organisational Integrity
Healthcare organizations that do not perform sanction checks are often at very high risk of hiring underqualified individuals. This directly impacts the quality of services they provide. Sanctioned or excluded individuals often have a background of unprofessional behaviour. Healthcare sanctions checks contribute positively to the hiring process. It ensures that the organization only works with well-qualified professionals, whether they are doctors, nurses, or other staff.
Different Types of Checks That Are Crucial for Healthcare Organizations
The table below mentions some of the crucial sanction checks performed in the healthcare sector:
| Type of Sanction Check | Purpose | What It Verifies | Who Performs / Maintains It |
|---|---|---|---|
| OIG LEIE Check | Identify excluded individuals/providers | Exclusion from Medicare & Medicaid | Office of Inspector General (OIG), U.S. |
| SAM / EPLS Check | Federal debarment verification | Individuals/entities barred from federal contracts | System for Award Management (SAM.gov) |
| State Medicaid Exclusion Check | Verify state-level exclusions | Providers banned from state Medicaid programs | State Medicaid agencies |
| OFAC Sanctions Check | National security and anti-terrorism compliance | SDN list, blocked entities, embargo violations | U.S. Treasury – OFAC |
| State Medical/Nursing Board License Check | Professional license validation | Active license, suspensions, disciplinary actions | State licensing boards |
Role of OIG Screening in the Sanction Background Checks
OIG screening is a crucial part of sanction checks, during which individuals and vendors are screened against the OIG’s LEIE (List of Excluded Individuals/Entities). This list contains the names of individuals and entities that are excluded from participating in federally funded programs. OIG screening filters out individuals and vendors excluded by OIG. Consequently, it saves healthcare organizations from exclusion risks.
How to Perform OIG Screening?
In most cases, OIG checks are performed manually using OIG’s database. This database is publicly available via online search engines, and basic background checks are as simple as finding basic information about any organisation online. Furthermore, here are some crucial steps to conduct OIG sanction checks that you must know.
- Analyse individuals/entities by simply searching by their names or National Provider Identifier (NPI).
- Download complete monthly update sheets/lists for mass or bulk searches. Therefore, it is a more convenient way to get precise information about the individual.
- It is beneficial to use named variables to avoid false misconceptions during OIG Exclusion in sanction checks.
However, manual screening can take a significant amount of time depending on the healthcare organization’s size. That is why Venops provides automated sanctions checks and OIG screening with advanced software tools. This not only improves the screening accuracy but also increases the screening speed.
Wrapping It Up!
We hope this article provided you with all the key information on why sanction checks are essential and why OIG screening is vital to this process. At Venops, we offer sanction screening software that enables compliance teams to review all lists, screenings, and exclusions with ease. We use the most up-to-date information available, and our software can be used for single-name as well as bulk-processing to assess all working employees and individuals with confidence. So, what are you waiting for? Enroll with us today and get the premium services!
FAQs
Q.1: Can I rely on automated software tools for sanction checks and screening?
A: Yes, automated software tools used for screening and sanction checks are highly reliable and can be trusted. That is precisely why we provide automated screening services at Venops for notably improved speed and accuracy.
Q.2: What are the possible reasons for OIG exclusion?
A: Possible reasons for OIG exclusion are listed below:
- Medicare or Medicaid fraud
- Patient abuse or neglect
- Felony convictions related to healthcare, controlled substances, or financial crimes
- License revocation or suspension
- Submitting false claims
- Kickbacks or improper financial relationships
- Diversion of controlled substances
For complete details on the exclusion grounds, refer to this link.
Q.3: Why should I choose Venops for third-party screening services?
A: At Venops, we have a considerable amount of experience in providing compliance and screening services to numerous healthcare organizations. Our wide range of services includes vendor screening, staff screening, automated monthly screening, ad hoc screening, and CMS reporting. Moreover, you get all the world-class services at the right price.
Q.4: Why is it challenging to perform sanction checks manually?
A: Performing sanction checks manually requires a considerable amount of time and resources. Additionally, the risk of inaccurate screening is always high due to the unavailability of experts. That is precisely why experts suggest a third-party compliance screening provider to ensure accurate checks.
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