In-Depth Articles

Current States With Separate Exclusion Databases

I. Medicaid Exclusion Exclusion Screening, LLC conducts monthly checks of our clients’ employees, contractors, and vendors against the OIG-LEIE, GSA-SAM, and all available state lists. Most providers understand that they have an obligation to check their employees, contractors, and vendors against the OIG-LEIE prior to hiring and monthly thereafter. Fewer providers are aware of their […]

Who Should Be on my OIG Exclusion List?

I. Federal and State Agencies Conducting Audits As many health care providers and suppliers have painfully learned over the last year, federal and state law enforcement agencies, along with many of the contractors with whom they work, are actively conducting audits of Medicare and Medicaid claims submitted to the government for coverage and payment. One […]

Which Exclusion Lists Need to Be Screened? What Is the Difference between Them?

There are two federal databases that list persons and entities that have been excluded from participating in federal health care programs or receiving federal contracts. Checking and verifying individuals on the List of Excluded Individuals and Entities (LEIE) and the System for Award Management (SAM) should be part of any compliance exclusion screening program. The LEIE is […]

How to Apply for Reinstatement

I. The Reinstatement Process             Most exclusions are imposed for a definite time period. The question for an excluded individual or entity is: What happens at the end of the exclusion period?        The answer is that the excluded individual or entity must apply for reinstatement. The U.S. Department […]

Gary Cantrell Testimony: Failures to Report Adverse Licensing Actions Leads to Gaps in the OIG-LEIE

HHS/OIG Deputy Inspector General Gary Cantrell testified earlier this year that States are failing to report all of the adverse actions taken by their Licensing Boards. He suggested that the “manner and time of the [reported] notices” are unreliable. Cantrell attributed these concerns to the “voluntary” nature of State reporting obligations.[1] I.  The Impact on Exclusion […]

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