Whether hiring individuals or contracting a service provider, healthcare organizations must be extra cautious. Any kind of inadequacy during the background checks can lead to severe financial penalties and reputational loss. You can avoid these consequences by screening your potential hires and vendors against the prominent databases and lists. OIG screening, SAM, and OFAC are some of the crucial screening processes for healthcare organizations. Screening against these lists ensures that you only work with well-qualified parties with no criminal record.
Regular and accurate screening of employees in a healthcare organization has a direct impact on its services. The screening process prevents you from working with individuals and entities involved in fraud, misbehaviour, and criminal activities. Consequently, patients feel much safer and get appropriate services. In this blog, we will cover different screening lists and explore the role of OIG screening in the healthcare hiring process.
Screening Lists in Healthcare and Their Role in Ensuring the Organization’s Safety
The hiring process for the healthcare industry is regulated by laws, and for good reasons. Healthcare organizations are responsible for people’s health. Thus, they cannot hire personnel carelessly. We have mentioned below the details of the lists and databases that play a crucial role in the screening process:
| Database / List | Screening Process in Healthcare Organizations | Role in Ensuring Safety & Compliance |
|---|---|---|
| OIG Exclusion List (LEIE) | Check employees, vendors, and contractors against the OIG’s List of Excluded Individuals/Entities at the time of hiring and monthly thereafter. | Prevents hiring/contracting with individuals/entities excluded for fraud, abuse, malpractice, or other misconduct. Ensures eligibility for Medicare/Medicaid reimbursements. |
| SAM (System for Award Management) | Screen individuals and companies against the SAM database for federal debarment or suspension. | Ensures organizations do not partner with vendors barred from federal contracts. Protects against misuse of federal funds. |
| OFAC Sanctions List (SDN List) | Cross-check employees/vendors with the Treasury’s Specially Designated Nationals (SDN) list. Often automated with compliance software. | Prevents dealing with individuals/entities sanctioned for links to terrorism, narcotics, or international threats. Protects national security and financial integrity. |
| State Medicaid Exclusion Lists | Screen employees and vendors against state-specific exclusion lists in addition to the OIG. Many states require monthly checks. | Captures exclusions not yet reported to the federal OIG. Prevents fraud/abuse at the state healthcare program level. |
| National Practitioner Data Bank (NPDB) | Query NPDB during credentialing and re-credentialing for physicians, nurses, and licensed providers. Checks malpractice, disciplinary actions, or license restrictions. | Ensures only qualified, ethical, and safe healthcare practitioners provide care. Protects patient safety and trust in clinical staff. |
Significance of Screening Employees in the Healthcare Industry
The significance of employee and service provider screening can be understood with the following points:
1. Ensuring Patient Safety
Hiring qualified doctors, nurses, and other healthcare staff with no criminal record makes a significant contribution to patient safety. Doctors and medical staff who are not OIG excluded, or present in any other exclusion list, are capable of performing their duties professionally. This is directly related to excellent patient treatment and their safety.
2. Regulatory Compliance
Healthcare organizations must operate under strict laws and regulations. The hiring process also falls under these regulations. They must not hire professionals who are not involved with illegal activities. Doing so makes the healthcare organization liable for financial punishment and imprisonment, in the worst-case scenario. OIG screening and other screening processes protect healthcare organizations from such risks.
3. Prevents Financial Loss
Many excluded parties are involved in financial fraud, and working with such individuals puts the healthcare organization at risk. Screening against different federal databases removes the possibility of hiring such individuals. This, in turn, saves the healthcare organization from financial loss.
4. High-Quality Services with Timely Delivery
Vendor screening is also covered in these checks, where the backgrounds of vendors and other service providers are checked thoroughly. Partnering with a credible and reliable vendor ensures that you get medical supplies, equipment, and emergency services right on time.
Role of OIG Database in the Screening Process for Healthcare Providers
OIG background checks or screening is one of the most prominent ways to ensure complete verification for healthcare industry hiring. OIG exclusion means that the individual or entity is prohibited from participating in any federal healthcare program. If a healthcare organization is found to be working with such excluded parties, it will face civil monetary penalties (CMPs) and other fines, depending on the severity of the offense.
Who are OIG Excluded Individuals and Entities?
OIG, or the Office of Inspector General, excludes parties based on serious grounds. An OIG excluded party can be involved with the following unlawful activities:
- Medicare or Medicaid fraud, or any other fraud involving federal healthcare programs
- Neglecting professional duties and abusing patients
- Unlawful handling of controlled substances, including manufacturing, distribution, and prescription
- License revocation, suspension, or surrender due to the inability to perform professional duties
- Claims for unnecessary or substandard healthcare services
- Kickbacks, bribes, or false claims related to healthcare services
As mentioned above, the charges for exclusion are serious, which is why working with such individuals is dangerous. They can bring down the quality of healthcare services, leading to reputational loss. In the healthcare industry, losing reputation among patients can have a lasting impact. Due to this, experts recommend performing the screening process regularly.
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Here is why you should choose us:
- Additional vendor screening services without any extra cost
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