Office of Inspector General Search

The Office of Inspector General (OIG) has the authority to conduct the Medicaid, Medicare and Federal sanctions.

The report consists of entities, parties or individuals that are prohibited from participating in any type of government program. Furthermore, the report also includes General Services Administration (GSA) sanctions list checks.

Helps Protect Organization from Losing Accreditation or Being Fined

The Office of Inspector General (OIG) has a responsibility according to sections 1128 and 1156 of the SSA (Social Security Act) to exclude certain entities from health programs that are federally-funded. A List of Excluded Individuals and Entities (LEIE), is also maintained. As per the SSA, no Federal Health Care program can be provided for items or services that are furnished by an entity or individual that is excluded.

Therefore, Medicaid, Medicare and all other Federal programs and plans are included which provide health benefits that are funded directly or indirectly by the government of the United States. It is due to this reason that healthcare organizations which receive payments from a federal health care program are required to verify subcontractors, contractors, vendors, and others as they have not been included in the state and federal excluded and sanctions entities databases.

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Civil Monetary Penalties

The health care organization that does receive payment from the federal health care program for services or items that are furnished by an excluded entity would be subject to CMP (Civil Monetary Penalties), and it would damage their reputation.

In addition to the above, health care organizations must perform ongoing sanction checks in order to obtain certification and accreditation from the National Committee for Quality Assurance (NCQA) and the Joint Commission, Utilization Review Accreditation Commission (URAC).

Main Benefits

There are certain benefits of this procedure as listed below.

Help save time by eliminating the need to have various exclusion lists manually checked.
Protects the organization from have to pay civil monetary penalties that might have been imposed for engaging with excluded contractors that are sanctioned.
Identifies contractors or suppliers that have sanctions or exclusions.

Excluded Entity Search Products

There different companies out there that conduct real-time search for the primary source excluded entity databases. The records are then identified and matched by the exactly same entity name as had been provided and the tax id and address of the said entity.

OIG-GSA Exclusion Entity

The search can be conducted on the US General Services Administration’s (GSA) System for Award Management (SAM) and the List of Excluded Individuals/Entities (LEIE) of the Department of Health and Human Services Office of the Inspector General (DHHS OIG) in order to identify if the said entity is excluded from participating in Medicaid, Medicare, or any other Federal health care program.

Health Care Sanctions – Entity

For this search, organization are indentified which might have been excluded or sanctioned from participating in both state and federal health care programs, including exclusions, state and federal sanctions, along with the debarment lists across all of the 50 states. Initially the search is performed as a tip or lead search in respect of an aggregated database, then, if there is a possible match that is returned, an additional search would be performed directly with the primary source. Then, organizations would be provided with legally reportable records after having applied it to matching and reporting guidelines.

Entity Screening

The Entity Screening offers an easy-to-read summary report for organizations. Instead of having to sort through thousands and thousands of records, one would benefit from the report as it identifies adverse information that is associated with that particular entity searched. The search is extremely useful.