Healthcare Sanction Checking

As we observe Patient Safety Awareness Week at PreCheck, I thought I would discuss the important role that an effective background screening process plays in patient care and safety. During this time, background checks may be overlooked as a patient safety initiative, but they play a key role in safeguarding both patients and healthcare organizations from harm.

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 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).

There’s been no shortage of stories regarding home healthcare background screening practices in recent years. In fact, here are three noteworthy developments from 2014 alone. As we approach 2015, now may be an opportune time to review your organization’s background screening policies.

It’s that time of the year again and I don’t necessarily mean it due to the upcoming holiday season. On October 31^st, the U.S. Department of Health and Human Services released its Work Plan for the fiscal year 2015, which summarizes new and ongoing reviews and activities the Office of Inspector General (OIG) will pursue in the coming year and beyond. As a healthcare background screening firm, I thought I would highlight four key areas from the 2015 Work Plan that contain background check-related implications for healthcare organizations.

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.

Background checks are a fundamental practice for hospitals to ensure safety amongst patients and staff alike. A highly regulated industry like healthcare is urged to apply more stringent policies due to the fact that lives are at risk every day and patient-sensitive information can be easily accessed.

FBI fingerprint background checks have gained popularity. When it comes to state legislation regarding background screening requirements for healthcare organizations like home health agencies, for example, FBI background checks are one of the most commonly required types of searches. If legislators are consistently requiring them, they must be a comprehensive background check, right?

In March, the OIG published a report titled, “CMS’s Process for Sharing Information About Terminated Providers Needs Improvement.” As the title suggests, DHHS has determined that CMS does not properly share information regarding terminated providers with other states. As we’ve discussed before, section 6501 of the Patient Protection and Affordable Care Act (ACA) requires State Medicaid programs to terminate participation of providers if terminated under Medicare, another State Medicaid program, or CHIP.

Earlier this year, we addressed some of the frequently asked questions concerning exclusion and sanction screening. This article focuses on the current recommended best practices for the healthcare industry, given the latest publicly available exclusion information, as well as recommendations and guidelines from regulatory agencies.