Why Your Health Care Organization Needs An Automated Exclusion System

If you are in the health care industry, you know that compliance is not a walk in the park. For starters, there is no one-stop-shop for all the exclusion and debarment data you need to check on a monthly basis – you will have to have both the OIG LEIE and the GSA Excluded Party List System as references. There are also appropriate timeframes to meet for reporting, plus continuous upgrades on regulations and a growing list of excluded parties and individuals to deal with. There are expensive and stressful repercussions if you neglect a single one of them.

The most helpful solution is an automated system that ensures you meet all exclusion screening requirements in a timely manner. Along with providing a foolproof OIG verification system, it also addresses several screening issues.

You can minimize human error.

Human error has been known to trump good intention. In the case of health care exclusion, human error can mean millions of dollars in fines, and much legal wrangling to salvage your reputation. Even Self-Disclosure reports have to follow a strict set of guidelines and processes to be accepted by the OIG. You can’t get a reprieve simply because you neglected to follow one tiny detail.

A reliable verification software can easily perform OIG exclusion list checks on multiple employees. When screening is done manually, it’s possible to miss some name variations of excluded individuals, and even deadlines. An automated system not only checks on multiple employees against all OIG and state exclusion databases; it can check all name variations and diminutives, too. It also has the capacity to access compliance-proving reports every 24 hours.

Screening can get tedious.

It is your job to verify all employees against all exclusion databases on a monthly basis. This means checking all versions of an employee’s name, including diminutives or nicknames, combined names, and maiden names. And as previously mentioned, there is no single reliable exclusion database you can refer to. Aside from those excluded by Federal laws, each state can have its own reasons for excluding entities and parties. This means checking nationwide databases every single month to be on the safe side.

A comprehensive verification service lifts the burden of exclusion screening from your shoulders. It performs an ongoing, monthly OIG exclusion list check. It can also automatically receive monthly emails with updated verification results and newly flagged matches.

Exclusion figures are alarming.

As this 2014 Exclusion Fines infographic illustrates, each state can rack up millions of dollars in fines due to non-compliance. Last year’s total amount in fines was a staggering  $10,551,827.90. No health care organization is safe from potential liability this huge. Whether you’re with a hospital, pharmaceutical services, EMS, dental practice, health care staffing, University/college clinic or lab, or any other type of health care provider answerable to state and Federal laws, you can be subject to civil monetary penalties.

OIG compliance can be simple if you choose it to be. Avoiding steep fines and administration investigation-related costs is possible. An automated solution is a must so you can address exclusion screening issues without the hassle and stress.

About the Author:

StevenGrossmanSteven Grossman joined Streamline Verify in 2011, and has since been closely involved in the company’s development and implementation of current operations in account services, marketing, contracting, and compliance. He also shares responsibility for oversight of all facets of Streamline Verify’s customer relationships.

Mr. Grossman is affiliated with the member-based Health Care Compliance Association, a non-profit organization for compliance professionals in the health care field. He managed his family’s retail business for several years before joining the health care industry.


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