For any healthcare organization, patient safety, service quality, and regulatory compliance all depend on the people and organizations it chooses to work with. Although many organizations view OIG Screening primarily as a means of complying with applicable laws and avoiding penalties or legal issues, this type of screening offers many additional benefits for the healthcare industry. Furthermore, it allows healthcare facilities to build a better, more trustworthy workforce.
Employees, physicians, third parties (contractors, suppliers, billing partners, etc.) are always being recruited or contracted to work with healthcare facilities. Each individual or vendor associated with a healthcare organization plays some role in treatment and healthcare provision. Consequently, even a single problematic employee in the organization can be highly dangerous from the perspectives of compliance, operations, finances, and reputation.
This is when screening of individuals against the OIG exclusion list plays a crucial role for healthcare providers. It allows them to avoid engaging with people and organizations that could threaten their business.
An Overview of OIG and Its Fundamental Importance in the Healthcare Sector
The Office of Inspector General is an independent agency that protects federally funded healthcare programs (such as Medicare and Medicaid) from fraud, abuse, and other misconduct. To fulfill its duties, the OGI maintains a list of excluded individuals and entities (LEIE). It includes individuals and organizations prohibited from working within the realm of Medicare and Medicaid programs.
When screening their employees and third parties, healthcare organizations should make sure that those individuals do not appear on this list. Also, since the OIG exclusion list is regularly updated, routine screening is required.
In addition to helping healthcare providers avoid penalties, OIG screening aims to build trustworthy, qualified workplaces by preventing the hiring of individuals involved in unethical or illegal activities. For instance, many individuals appearing on the OIG exclusion list are associated with cases of Medicare/Medicaid fraud, patient neglect, scams, prescription drug abuse, or professional misconduct. Therefore, by regularly performing vendor screening, healthcare organizations can provide better care to their patients. Here, we have mentioned the significance of OIG in the healthcare sector:
1. Grounds for Exclusion
Exclusion by the OIG is not minor or insignificant. On the contrary, the reasons behind this are always serious. Knowing them can help you understand why screening is really important.
2. Medicare/Medicaid Fraud
Committing crimes and engaging in fraudulent activities related to billing, payments, and the overall operation of Medicare or Medicaid is grounds for mandatory exclusion.
3. Patient Abuse or Neglect
Any crime involving physical or emotional abuse or neglect towards a patient automatically makes an individual eligible for mandatory exclusion.
4. Healthcare Fraud Convictions
Any healthcare professional whose record shows convictions for healthcare fraud will receive mandatory exclusion.
5. Controlled Substance Violations
All individuals with a felony conviction concerning controlled substances (manufacturing, prescribing, distributing, or dispensing them) are required to be excluded.
6. License Suspension or Revocation
Being stripped of your license due to professional misconduct, incompetence, or violations of other requirements makes you ineligible to work in this sphere. Therefore, it results in a permissive exclusion.
7. Submission of Fraudulent Claims
If someone submits inflated or fraudulent medical claims, it will be a violation.
8. Obstruction of Audits or Investigations
Attempting to obstruct audit or investigative procedures will render an individual ineligible to practice in the field of medicine. Accordingly, it leads to permissive exclusion. Each of these criteria explains why healthcare organizations should regularly conduct background checks on their employees.
OIG Screening for Improving Workforce Quality
As mentioned above, OIG screening plays a significant role in improving the quality of the healthcare workforce. Here is how exactly screening helps healthcare organizations.
1. Hiring Quality and Trustworthy Professionals
First and foremost, exclusion screening allows healthcare organizations to hire professionals they can trust. While screening their future employees, employers can detect whether a candidate has previously had a compliance issue or committed fraud.
Therefore, organizations will hire employees whose actions and behavior meet both professional and ethical requirements. Naturally, it will lead to better-quality services provided by a healthcare facility.
2. Providing a Safer Working Environment
As we all know, physicians work directly with patients and need to prescribe medications or diagnose conditions. Therefore, having people who are not excluded work for you can help you build a safer workplace.
For example, if someone has committed patient abuse or neglect, they will never be allowed to work with your patients since you will filter out such individuals.
3. Vendor Screening and Selection
All healthcare organizations work with numerous vendors to obtain diagnostics, medications, equipment, and other supplies. However, sometimes, some organizations turn to suspicious vendors. Vendor screening allows organizations to work only with reputable and trustworthy vendors and contractors, reducing their risk of compliance issues, damage, or financial losses.
4. Optimal Vendor Management
Finally, OIG screening helps you choose the best vendors by identifying those that were previously excluded. Choosing reliable vendors will help you improve operational efficiency and receive deliveries faster and more cheaply.
5. Building Stronger Brand Image
Last but not least, healthcare providers need a good reputation to earn their patients’ trust. However, when you employ excluded individuals, you might ruin your reputation in minutes. Thus, through exclusion screening, organizations show their dedication to complying with laws and regulations. Consequently, their brand reputation improves.
6. Faster Hiring Process Through Regular OIG Monitoring
In most cases, healthcare organizations deal with high-volume hiring or an urgent need to recruit people. Such cases do not allow organizations to manually verify applicants’ backgrounds, as it might take too long. Nevertheless, with the help of vendor screening and automated software, they can complete the verification process quickly and without errors. Moreover, with automated screening software, organizations do not need to hire additional employees to check all the applicants.
The Significance of Continuous OIG Monitoring
Regular checking of people’s eligibility can help organizations to detect any violations committed by their employees. Nonetheless, if your OIG screening procedure ends with hiring and onboarding, it will be hard to detect any problems until you actually notice that something went wrong.
It will save you a lot of time to continuously monitor your employees’ backgrounds and detect any problems. As soon as any employee appears on the exclusion list, you will be immediately notified about it. Also, such a routine procedure will help organizations remain compliant with laws and regulations at all times.
Outsourcing OIG Screening Procedure: Why Should You Do It?
Performing the exclusion screening procedure yourself might not be the best idea. Moreover, your employees might lack experience in this area and cannot be completely trusted. Second, your company might simply lack the time needed for such activity. Hence, it is worth considering outsourcing this process to an experienced compliance provider. Here are the reasons why you should consider it:
- Save your time and resources
- Reduce the possibility of human error and false positives
- Ensure compliance with laws and regulations
- Scale your screening process
- Perform continuous OIG screening
- Facilitate recruitment and onboarding processes
It’s Time to Wrap Things Up!
OIG screening is crucial for every healthcare organization, and for this reason, it needs to be done fast and efficiently. To achieve this goal, you will need to find an organization that offers efficient screening services.
Venops has all the features you will require to make your screening process easy and fast. The organization uses automated OIG screening software, which helps eliminate errors or delays. They have up-to-date, comprehensive databases that meet all necessary requirements. Additionally, they perform all necessary verifications manually with the supervision of an expert. So, do not wait any longer. Contact them today!
