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Category: Exclusion Lists

Provider Termination FAQs

By support@poweredbygnosis.com

Sanctions, Exclusions, Terminations, Suspensions, and Debarment are administrative actions taken against an individual or entity by the Office of Inspector General (OIG), State Healthcare Program Agencies, the Medicaid Fraud Control Unit (MFCU), or one of the many agencies associated with the General Services Administration (GSA), for reasons that include fraud, integrity, or quality. For healthcare organizations, an individual or entity that is sanctioned or excluded by the OIG, terminated by a State Healthcare Program authority, or suspended or debarred by the GSA is prevented from participating in any Federal Healthcare Reimbursement Program, including Medicaid, CHIP, and Medicare programs, regardless ofLearn MoreProvider Termination FAQs

Medicaid Exclusions, Sanctions, Terminations – What’s the Difference?

By support@poweredbygnosis.com

The differences between sanctions, exclusions, and termination are crucial for healthcare organizations to understand when hiring and retaining skilled professionals. Sanctions A sanction results from an administrative hearing where an individual or entity violates an administrative rule, civil law, or criminal offense, leading to various penalties. Sanctions are enforced by the Office of the Inspector General (OIG) or a State Medicaid program authority. A sanction from a healthcare disciplinary or licensing board can lead to significant consequences, the most severe of which is an exclusion. Exclusions An exclusion results from an extreme sanction issued by the Office of Inspector General (OIG). Exclusions areLearn MoreMedicaid Exclusions, Sanctions, Terminations – What’s the Difference?

Exclusion Lists FAQs

By support@poweredbygnosis.com

Which exclusion list should I use to check employees and vendors, the OIG-LEIE or the GSA-SAM? It is recommended that you check both the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) and the General Services Administration’s (GSA) System for Award Management (SAM) databases, as well as all of the publicly available State Exclusion Lists. According to 42 CFR Part §455.436(b) — Federal database checks, State Medicaid agencies must: (b) Check the Social Security Administration’s Death Master File, the National Plan and Provider Enumeration System (NPPES), the List of Excluded Individuals/Entities (LEIE), the System for AwardLearn MoreExclusion Lists FAQs

SAM Suspension and Debarment FAQs

By support@poweredbygnosis.com

What are Suspension and Debarment? Suspensions and debarments are “administrative remedies” used to prevent the Government from working with parties who are not “presently responsible”. An individual or entity is not presently responsible if they engaged in criminal activity or other improper conduct, or have demonstrated serious poor performance to such a severe and compelling nature that it would lead to questioning their honesty, ethics, or competence. Federal agencies use these remedies to exclude parties from obtaining new Federal contracts, certain subcontracts (procurement), discretionary assistance, certain funded lower-tiered transactions, leases, loans, loan guarantees, and other benefits (non-procurement). Both suspended andLearn MoreSAM Suspension and Debarment FAQs

OIG, SAM, and State Exclusion Lists – What’s the Difference

By support@poweredbygnosis.com

You know it’s essential to screen new hires, current employees, and vendors against the Office of Inspector General (OIG) List of Excluded Individuals/Entities (LEIE), the General Services Administration (GSA) System for Award Management (SAM), and all available State Exclusion lists, but what’s the difference? HealthProviders DB is an unparalleled solution that allows users to effortlessly and simultaneously search OIG Exclusions, SAM Exclusions, State Exclusion Lists, FDA Debarment, and Clinical Investigators—Disqualification Proceedings—all in one powerful platform! The OIG List of Excluded Individuals and Entities (LEIE) The Office of Inspector General (OIG) maintains the List of Excluded Individuals/Entities (LEIE) that is updatedLearn MoreOIG, SAM, and State Exclusion Lists – What’s the Difference

State Exclusion List FAQs

By support@poweredbygnosis.com

Why do States have an Exclusion List? States are required to notify the Health and Human Services (HHS) Office of Inspector General (OIG) only when they exclude or terminate an individual or entity based on federal law. States are not required to notify the OIG (nor should they) of actions based on state laws because if the sanction fails to meet the criteria for a federal exclusion, the exclusion will not be posted on the LEIE. It can take several months for the OIG to process the State-reported sanction and determine if the OIG will also impose a federal exclusion based onLearn MoreState Exclusion List FAQs

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