Exclusion Screening

Last week, the 21st Health Care Compliance Association (HCCA) Compliance Institute was held in National Harbor, Maryland. Adjacent to our nation’s capital, Washington, D.C., National Harbor was the perfect location to hear from regulators such as the Office of Inspector General (OIG) and its various departments.

While most healthcare employers conduct some form of employment background checks to safeguard their patients and staff, these screenings should not be limited to the ones conducted at the time of hire. Indeed, background screening experts have identified the emergence of a new trend referred to as infinity screening. “Infinity screening is the process of conducting background checks on current employees on a periodic or ongoing basis to stay informed about life changes which could create increased risk for your organization,” W.

Healthcare exclusions can be costly for healthcare organizations. The Department of Health and Human Services (DHHS) Office of Inspector General (OIG) has authority to implement exclusions and exclude providers from participating in federal healthcare programs such as Medicare and Medicaid. If your healthcare organization engages excluded individuals or entities, you could be liable for civil monetary penalties (CMPs).

Here are five things healthcare organizations should know about healthcare exclusions:

Healthcare exclusion screening can be seen as one of the most complex and challenging areas of compliance. It’s one that demands your time, attention, and most importantly, due diligence to ensure you’re not working with excluded or sanctioned individuals.

At the start of a new year, I enjoy looking back at the previous year’s blog posts and learning what our readers considered the most noteworthy articles and topics from the PreCheck Blog.

At a glance, it’s clear our readers highly favored lists in 2016, with 60 percent of our top ten articles from last year comprising of lists. Healthcare HR trends, background check and I-9 compliance, and social media were among the most popular topics from the past year.

Managing and maintaining a compliant healthcare workspace can be a daunting and intimidating task. One wrong step can result in damaging claims, costly fines, and much more. From the Office of Inspector General (OIG) to the Equal Employment Opportunity Commission (EEOC), regulators are increasing deterrents efforts to ensure employers are proactive in establishing fair hiring practices and safe working environments.

With so much on the line, here are a few things healthcare HR should consider when reviewing their organization’s compliance and safety initiatives.

Patient safety is the backbone of healthcare and the National Practitioner Data Bank (NPDB) plays a critical role in protecting patients from unfit, excluded practitioners.  The NPDB serves its mission to promote quality healthcare and protect patient safety by operating as a reliable workforce tool for users engaged in credentialing, licensing and hiring decisions.

The U.S. Department of Health and Human Services (DHHS) Office of Inspector General (OIG) recently released an updated Mid-Year Work Plan for fiscal year 2016. The updated Work Plan summarizes new and ongoing reviews and activities that OIG plans to pursue in the current year and beyond. This edition of the Work Plan describes OIG audits and evaluations that are underway or planned, and certain ongoing legal and investigative initiatives.

Here’s what you need to know about the 2016 OIG Mid-Year Work Plan.

Last week, the 20th anniversary Health Care Compliance Association (HCCA) Compliance Institute was held in the beautiful Aria resort in Las Vegas, Nevada. While this city is usually associated with bad decisions, copious amounts of alcohol consumption, non-stop gambling (until your wallet permits, that is), it has some good parts, too. It’s a great place to celebrate the 20th anniversary of the Compliance Institute, for one. And despite its fast-paced environment, Vegas can also be a great place for healthcare compliance officers to share ideas, relax and unwind.

I recently attended an exclusion screening webinar from the Health Care Compliance Association (HCCA), “Everything You Always Wanted to Know About Exclusions But Were Afraid to Ask.” After listening to the 90-minute presentation with attorneys Mary C. Malone and W. Clay Landa from Hancock, Daniel, Johnson & Nagle, P.C., it was very clear that healthcare exclusion screening is an extremely complex and quite frankly intimidating area of compliance.