The last few years have been difficult for everyone. Understanding that the pandemic led to significant staffing shortages, along with the controversy surrounding the vaccine, healthcare providers have been scrambling for months to maintain adequate levels of staff and care. Today’s news story is a telling tale into the world of healthcare exclusion searches, and what can happen in the event violations of the OIG occur.
This story is based out of Connecticut, where two separate group practices were alleged to have improperly employed individuals who were excluded from the federal healthcare programs.
The Windham Eye Group, P.C. settlement was for $192,699 and Geriatric & Adult Psychiatry LLC was for $310,874.
Why?
Both practices were alleged to have billed and sought reimbursement from the federal health care programs during the time the excluded individuals were employed with a portion of such reimbursements used to pay the same individuals’ salary and benefits.
Two individuals, one a physician, and one a practice administrator had been convicted of health care fraud charges outside the state of Connecticut.
List of Excluded Individuals
These two individuals would be found on the federal Office of Inspector General’s List of Excluded Individuals. This list, as we have spoken about here on the blog, is a list of individuals who are EXCLUDED from past violations, and reports are that the list has grown significantly in recent months.
State and federal enforcement authorities are catching up on investigations and administrative proceedings that had been delayed over the last two years due to the pandemic.
Know The Laws of the OIG
Many times, name changes are common amongst people attempting to dodge the OIG LEIE, so a thorough background check may be necessary. Cross-checking social security and tax information could be helpful.
Routine checks should be made to not only remain in compliance but also help avoid hefty fines. Any and all staff, including volunteers, should be vetted with the LEIE. When you work with ESS you can trust that we have a streamlined approach to searching mass amounts of employees routinely. We work with large healthcare organizations all around the country to help provide healthcare exclusion checks.
With all the hectic changes in staffing, it can be easy to get eager on making hiring decisions to maintain care and productivity. Despite the COVID-19 pandemic, the law is the law, and if you don’t have a proper healthcare exclusion check workflow in place with a trusted background check partner with ESS, you could end up like one of these two Connecticut organizations, in a blog about what NOT to do…
If you have any questions regarding Healthcare exclusion checks or have a question revolving around your current background screening process, please don’t hesitate to give us a call or reach out via our contact form to talk to a professional today!
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