OIG Exclusion List - DoctorsManagement OIG Exclusion List - DoctorsManagement

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THE COMPLIANCE GUY BLOG

HHS/OIG Exclusion List Violations

June 7, 2021

by Sean Weiss, Partner & VP of Compliance

An important subject that should not be far from your mind is the OIG exclusions list. The HHS/OIG is not backing down on Employment of Excluded Individuals. On April 1 and again on April 6, one organization had two reportable Corporate Integrity Act (CIA) Events. After the company disclosed conduct to OIG pursuant to its CIA, the company and facilities it manages entered into settlement agreements of $121,783.31 and $38,384.96. OIG alleged they employed individuals “that it knew or should have known were excluded from participation in the California Medicaid program (Medi-Cal) and that no Medi-Cal payments could be made for items or services the individual furnished.”

April 1 reportable event

April 6 reportable event

 

Healthcare organizations are responsible for verifying not only their potential employees’ ability to hold employment but also vetting any vendors. the List of Excluded Individuals/Entities (LEIE) Database can be searched via this link: https://exclusions.oig.hhs.gov/

Don’t make a costly mistake, know the rules!

What to do next…

  1. If you need help with an audit appeal or regulatory compliance concern, contact us at (800) 635-4040 or via email at info@drsmgmt.com.
  2. Read more about our: Total Compliance Solution

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Experienced compliance professionals. Our compliance services are structured by a chief compliance officer and supported by a team that includes physicians, attorneys and a team of experienced auditors. The team has many decades of combined experience helping protect the interests of physicians and the organizations they serve.

Quality of coders and auditors. Our US-based auditors receive ongoing training and support from our education division, NAMAS (National Alliance of Medical Auditing Specialists). All team members possess over 15 years of experience and hold both the Certified Professional Coder (CPC®) as well as the Certified Professional Medical Auditor (CPMA®) credentials.

Proprietary risk-assessment technology – our auditing team uses ComplianceRiskAnalyzer(CRA)®, a sophisticated analytics solution that assesses critical risk areas. It enables our auditors to precisely select encounters that pose the greatest risk of triggering an audit so that they can be reviewed and the risk can be mitigated.

Synergy – DoctorsManagement is a full-service healthcare consultancy firm. The many departments within our firm work together to help clients rise above the complexities faced by today’s healthcare professionals. As a result, you receive quality solutions from a team of individuals who are current on every aspect of the business of medicine.