What is an OIG exclusion?
OIG has the authority to exclude individuals and entities from Federally funded health care programs and maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (LEIE). The effects of an exclusion are that no payment will be made for any items or services furnished, ordered, or prescribed by an excluded individual or entity. Additionally, anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties.
Why would an individual or entities be excluded?
OIG is required by law to exclude individuals and entities convicted of Medicare or Medicaid fraud, patient abuse or neglect, felony convictions for other health care-related fraud, and felony convictions relating to use of controlled substances. OIG has discretion to exclude individuals and entities on several other grounds. The full list can be viewed on oig.hhs.gov.
Why use exclugo?
To avoid civil monetary penalties, health care entities need to routinely check that their new hires and current employees are not on an excluded list. There are a few lists that must be searched including the OIG’s List of Excluded Individuals/Entities (LEIE), SAM.gov and state exclusion sites. Each of these lists has their own system and format. Searching each one monthly is a great burden on already overworked HR professionals. Additionally, verifying the many false positives that come from searching the lists monthly is tedious and time consuming. That is where exclugo comes in.
How can exclugo help my company?
We automate the Exclusion checking process, taking the burden away from you and your staff, freeing you up to do more important things. Using forward thinking technology, we integrated exclugo with ApplicantSafe so that the OIG exclusion check can be run before hire as part of the background screening process. Once an individual is in our monitoring databank, the name is continuously monitored providing a system that is truly hands off from pre-hire through employment and throughout employment.
What is the exclugo process?
Our unique system is built for use during the background check process with a exclusive “pre-hire” status. Individuals entered via a background check are under “pre-hire” status allowing them up to 6 months before being added to payroll. Periodically, a payroll list will be requested which will be used to cross reference those names in our system and on your payroll list. Names that are not found on the payroll list anymore will be removed from monitoring.
The Exclusion check process starts when an individual is entered into exclugo via a background check, upload or payroll list. It is run through our database of up-to-date exclusions from the OIG’s LEIE, SAM.gov and many state exclusion lists. False positives are weeded through by our experienced team. Only a verified positive hit is reported. The name is continuously monitored for possible new exclusions.
Will we be notified about arrests and criminal offenses?
Arrests and criminal offenses often do not result in an Exclusion and are not part of exclusion monitoring. You will be notified when a criminal offense does result in an exclusion.
Who uses exclugo?
Healthcare companies, just like you, who know that smarter technology equals better compliance and less manual work. They know that entrusting Exclusion checks to exclugo’s professional and experienced team provides many benefits including
- Automation (no need to sending over monthly spreadsheets)
- Integration (our integrations with payroll companies eliminate the need for you to send payroll lists)
- Security (we use the employee’s social security number and additional identifiers to get a greater picture of your employee’s previous address history)
- Continuous (once a name is entered, it will be monitored until the employee has left your payroll list)
- Verification of false positives (we only provide you with verified results)
- Experience (this is what we do everyday!)