SureCheckUSA OIG Exclusion Checks. The Health and Human Services Office of Inspector General’s (OIG) mission is to detect and root out fraud in Federal health care programs, including Medicare and Medicaid. Fraud diverts scarce resources meant to pay for the care of patients and other beneficiaries.
OIG’s efforts to curb fraud include:
- Conducting criminal, civil, and administrative investigations of fraud and misconduct related to HHS programs, operations, and beneficiaries.
- Using state-of-the-art tools and technology in investigations and audits around the country.
- Imposing program exclusions and civil monetary penalties on health care providers because of criminal conduct such as fraud or other wrong doing;
- Negotiating global settlements in cases arising under the civil False Claims Act, developing and monitoring corporate integrity agreements, and developing compliance program guidance.
The number of investigations, convictions and fines collected by OIG along with state and federal law enforcement has steadily continued to rise each year. Healthcare compliance departments can be overwhelmed with performing monthly searches of all federal and state exclusion and sanction lists for employees, contract workers and vendors. Improperly billing Medicare or Medicaid for services provided in part or whole by individuals or vendors currently excluded may result in significant fines.
Below are just a few of the recent fines imposed on healthcare providers for filing such claims:
- December 2019 – a Maryland dentist is fined $94,000.
- November 2019 – a Texas endoscopy center is fined $121,000.
- October 2019 – an Indiana nursing facility is fined $51,000.
- September 2019 – a Texas physician is fined $53,000.
- June 2019 – an Illinois hospital is fined $125,000.
- May 2019 – a Tennessee hospital is fined $102,000.
SureCheckUSA’s service provides secure automated monthly checks of federal and state exclusion and sanction data sources. These include LEIE, SAM, OFAC, FDA, Medicare Opt Out, SSA Death Master File and available state exclusion lists. The SureCheckUSA service is an inexpensive way for healthcare facilities to exercise due diligence in searching exclusion and sanction lists on a monthly basis. Improper billing for services related to an excluded individual or entity is easily avoided with SureCheckUSA’s monthly OIG sanction exclusion check service. Additionally, our experienced staff perform all necessary resolutions of search results freeing up your staff’s valuable time.
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