What Is the OIG Exclusion List?

 

Since 1977, the federal government has published a list of providers who have been barred from receiving federal payments due to specific infractions. This database is now known as the List of Excluded Individuals/Entities and is maintained by the Auditor General (OIG State Exclusions) at the Department of Health and Human Services.

For healthcare businesses, the LEIE is a critical component of compliance. The OIG State Exclusions, on the other hand, does not issue warnings or alerts to excluded providers. Organizations must examine the database regularly to ensure that their practitioners or possible new employees are not included.

Here's why the LEIE is crucial to healthcare providers, how exclusions affect companies, persons, and organizations, what exceptions apply, and how we employ the LEIE as part of a complete compliance program to safeguard your company from financial and reputational risk. 

What Are The Effects Of Exclusion?

The OIG enacts exclusions in two ways: obligatory and discretionary. Mandatory exclusions are imposed by law and require the OIG Exclusion Search to exclude a person or entity convicted of felony crimes such as Medicare or Medicaid fraud or other felony offenses involving state or federal healthcare programs; felony convictions involving illicit substances; or verdicts for patient neglect or abuse. The OIG Exclusion Search has discretion regarding exclusions under permissive exclusions. Permissive exclusions are considered minor violations.

Who Are We?

We've both worked in health care for a long time – Robert as a hospital administrator in 1984 and Paul with the introduction of HIPAA in 1996 – and we know firsthand that most providers are dedicated to providing high-quality treatment and following the laws. But what if a provider is faced with laws or regulations that are difficult to comprehend, expensive, and nearly impossible to follow?

We couldn't let go of the frustration of not being able to find a decent answer. Was it conceivable, we wondered, that such an essential commitment could be so difficult to fulfill? As you might have predicted, we never came up with a solution to the problem, so we made one! As such, please accept our warmest greetings from Exclusion Screening, LLC.