OIG exclusions and monitoring screening... Automated

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Through the exclusion screening process, healthcare organizations can identify whether an individual is excluded from participation in state or federal health care programs.

This acronym stands for the List of Excluded Individuals and Entities. Being on this list implies that a party is sanctioned from performing any services or providing goods associated with public healthcare programs.

Warnings are not sent out when someone is entered into the OIG exclusions list. Instead, employers must perform a search of several databases to determine whether their employee is excluded.

Some databases that must be searched include; the Federal Office of the Inspector General’s Exclusion List database; SAM.gov; and each state’s Medicaid Exclusion Database. Some states may require employers to search other databases as well.

An OIG exclusion screening search involves several key steps, they are as follows:

• The employer goes to the database they intended to search.
• Then the employer enters their employee’s name and date of birth.
• Now a list of potential matches will be presented. This list will contain all individuals with similar names and birth dates.
• Employers now must check to see if the excluded person is, in fact, their employee.
• For the best results, it is imperative that employers search for every version of an employee’s name, including their maiden names, combined names, and even shortened diminutives.