Healthcare Compliance

Although there are currently no bylaws instating the requirement of exclusion checks, the Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) mandates employers to know the exclusion status of their employees and contractors during their entire lifecycle with the company. According to the OIG, there are over 66,000 healthcare providers that are currently excluded from all federal healthcare programs.

In a January, 15, 2015 letter, Gloria L. Jarmon, Deputy Inspector General for Audit Services at the Department of Health and Human Services (DHHS), responded to a November 20, 2014 letter from Melinda Reid Hatton, Senior Vice President and General Counsel at the American Hospital Association (AHA).

Most employers conduct background checks before hiring a new employee, but it’s a different picture for current employees. While post-hire background checks may not be the norm across industries, there are a few key reasons why a heavily regulated industry such as healthcare might choose to adopt this practice. Pre-employment background checks can mitigate risk during the hiring process, but with patient and staff safety at stake, it’s important to keep healthcare organizations safe in the long-term.

The Fair Credit Reporting Act (FCRA) is a federal law that regulates the collection dissemination, and use of consumer information, including background checks and credit reporting. Over the past year, there has been a “swelling tide” of FCRA litigation against employers for improper use of background checks. Earlier this month, Genesis Healthcare, one of the largest nursing home chains in America, was sued for using background checks in a way that violates the FCRA.

2014 was phenomenal year for the PreCheck Blog. Not only did we double the amount of articles featuring healthcare experts and best practices, but the PreCheck Blog also won multiple prestigious awards, including being recognized as “Best Blog Website” by the Web Marketing Association. As we look forward to another great year of best practices for healthcare compliance, HR, and medical staff services teams, here’s a look back at the top ten most-read PreCheck Blog posts from 2014.

The Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) contains over 66,000 healthcare providers that are currently excluded from all federal healthcare programs. Any healthcare organization that hires an individual or entity on the LEIE can be subject to civil monetary penalties (CMP).

Yesterday, we discussed what healthcare human resources professionals should consider in order to comply with the Patient Protection and Affordable Care Act’s (PPACA) upcoming deadlines in 2015. HR leaders, however, are not the only ones who should be concerned with the implications of PPACA. Although not new for 2015, PPACA contains numerous provisions that expand the U.S Department of Health and Human Services (HHS) and the Office of Inspector General’s (OIG) authority to pursue allegations of healthcare noncompliance.

The Society of Corporate Compliance and Ethics (SCCE) and the New York Stock Exchange (NYSE) Governance Services recently released the results of the 2014 Compliance and Ethics Program Environment Survey. While this is not a healthcare-exclusive study, 31% of respondents were from a healthcare or social assistance organization, making healthcare the largest industry represented.

We recently discussed how often hospitals should run background checks on employees, but what about healthcare organizations in general? Even for non-hospital care organizations, patient care is still a concern. In fact, in its most recent work plan, the Office of Inspector General (OIG) stated it would continue to focus on the safety of long-term healthcare facilities in 2014 and beyond.

The Patient Protection and Affordable Health Care Act (PPACA) includes section 6002, which is also known as the Physician Payment Sunshine Act. This section requires pharmaceutical, medical device, biological, and medical supply manufacturers to report to the U.S. Department of Health and Human Services (DHHS) any “payment or other transfer of value” to physicians and teaching hospitals.