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....
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...
How Screening Differs by Healthcare Industry Sector
January 3, 2023
DOWNLOAD PDF Streamline Verify has worked many organizations in the healthcare industry during our many years in business. In addition to health plans, hospitals, universities and physician groups, we are privile...
Recent Additions to California’s Medi-Cal Exclusion Screening Databases
December 7, 2022
The California Medicaid program, known as Medi-Cal, is a highly regulated program by any measure. California takes a very intensive approach to assure that organizations offering services to Medicaid recipients meet a ve...
The Lone Star State’s Commitment to Exclusion Screening
July 22, 2022
The Texas Office of the Inspector General for the state’s Health and Human Services agency recently published a reminder about the significance of exclusion screening. Texas, like many states, maintains a state exclusi...
DOJ False Claims Highlights in 2021 and What to Expect Ahead
July 8, 2022
Over the past 5 years, there has been a decreased in false claims recoveries by the DOJ. That trend was resoundingly reversed in fiscal year 2021. In a press announcement on February 1, 2022, the DOJ released the foll...
Screening Volunteers Against Exclusion Lists – Things to Consider
June 30, 2022
Background In 2013, the OIG issued an updated revised bulletin regarding the effect of exclusion from participation in federal programs. As part of that bulletin, the OIG addressed a number of somewhat gray areas incl...
The Role of Delegated Entities in Exclusion Screening
December 14, 2021
Under federal law, Medicare Advantage plans and Part D plan sponsors may delegate administrative or healthcare service functions to third parties, such as a medical group, pharmacy benefit manager, claims administration ...
Employers – Dig Deeper! The Role of Abuse Registries in Employee Screening
November 24, 2021
There are specific screening requirements for health care employers who receive federal funds as participants in federally-funded health care programs, but screening against abuse registries is an often-overlooked resour...
