Healthcare organizations must screen against the OIG SAM databases to ensure they do not work with individuals or entities excluded from federal healthcare programs like Medicare and Medicaid. The Office of Inspector General (OIG) maintains the List of Excluded Individuals/Entities (LEIE), updated monthly, while the System for Award Management (SAM) tracks exclusions from federal contracts, updated annually....
Enhancing License Monitoring: Key Updates from NCQA
May 14, 2025
Organizations engaged in credentialing and accreditation are facing strengthened requirements from NCQA concerning ongoing monitoring of licensures. This move emphasizes the heightened responsibility to track licensure s...
Navigating the 2025 NCQA Updates: A Guide to License Monitoring and Compliance
April 23, 2025
In today’s rapidly evolving healthcare landscape, staying compliant with updated credentialing standards is more crucial than ever. The National Committee for Quality Assurance (NCQA) has introduced significant updates...
OMIG Exclusion Explained: Stay Compliant with NY Medicaid Rules
April 4, 2025
OMIG Exclusion: What It Is and How to Check New York’s Medicaid Exclusion List Healthcare compliance officers in New York face strict obligations when it comes to screening for excluded providers. One critical task ...
Exploring Recent Developments in OIG’s Enforcement Landscape: The Growing Willingness to Forego CIA’s
January 28, 2025
The healthcare compliance landscape is one of perpetual evolution, shaped by the ever-changing regulatory environment and enforcement practices. At the core of ensuring compliance within federal healthcare programs lies ...
Exclusion from Participation in Federal Health Care Programs
October 10, 2024
IntroductionUnder Sections 1128 and 1156 of the Social Security Act (the “Act”), the Office of Inspector General (“OIG”) of the U.S. Department of Health and Human Services (“HHS”) has authority to exclude fr...
Enhance Efficiency with OIG Compliance Software Solutions & Technology
July 29, 2024
Healthcare businesses — hospitals, medical practices, health insurers, medical device manufacturers, and the like — live in a world of heavy regulation. That regulation comes from the Office of the Inspector General ...
New OIG Opinion on Patient Assistance Programs: A Checklist for Maintaining a Compliant PAP
May 28, 2024
Based on OIG guidance from the United States Department of Health and Human Services Office of Inspector General (“OIG”), this article serves as a guide for non-profit, tax-exempt organizations under Section 501(c)(3...
Your Guide to Navigating Medicare Enrollment as a Hospice Provider
March 25, 2024
The exact steps for a provider or medical director of a hospice to enroll or opt-out of Medicare may vary, but generally, the process involves the following steps: Determine eligibility: Ensure that the provider or m...
