The Office of Inspector General (OIG) has the authority to exclude entities from Federally-funded health care programs, pursuant to sections 1128 and 1156 of the Social Security Act (the “SSA”), and to maintain a List of Excluded Individuals and Entities (LEIE). Under the SSA, no payment from any Federal health care program may be made for items or services furnished by an excluded individual or entity.
This includes Medicare, Medicaid, and all other Federal plans and programs that provide health benefits funded directly or indirectly by the United States government.
Healthcare organizations that receive payments from Federal health care programs, therefore, are required to verify that their vendors, contractors, subcontractors, etc. are not included in the federal and state sanctions and excluded entities databases.
Health care organizations that receive payments from Federal health care programs for items or services furnished by an excluded entity may be subject to civil monetary penalties (CMP), and damage to their reputation.
Additionally, to obtain accreditation and certification from The Joint Commission, Utilization Review Accreditation Commission (URAC), and the National Committee for Quality Assurance (NCQA), health care organizations must perform ongoing sanction checks.
Excluded Entity Search Products
HireRight conducts real-time searches of primary source excluded entity databases. Records are identity matched by the exact legal entity name provided and the entity’s Tax ID and address. “Doing Business As” (DBA) names, affiliates or subsidiaries will not be searched.
OIG-GSA (SAM) Exclusion - Entity
HireRight searches the List of Excluded Individuals/Entities (LEIE) of the Department of Health and Human Services Office of the Inspector General (DHHS OIG) and the US General Services Administration’s (GSA) System for Award Management (SAM) to identify if an entity is excluded from participating in Medicare, Medicaid, and/or other Federal health care programs.
Health Care Sanctions – Entity
This search helps identify organizations that may have been sanctioned or excluded from participating in both federal and state health care programs, including federal and state sanctions, exclusions, and debarment lists across all 50 states. HireRight initially performs a tip or lead search against an aggregated database and if a possible match is returned, HireRight performs an additional search directly with the primary source. HireRight will then provide legally reportable records after applying its matching and reporting guidelines.
HireRight’s Entity Screening delivers an easy-to-read summary report. Rather than having to sort through hundreds or thousands of records, the report identifies adverse information associated with the particular entity searched.
Attention business entities
If you need report copies or need to dispute information found on an entity search performed on your business please click the appropriate link above or contact HireRight at 1-800-381-0645 (Monday-Friday, 7am to 7pm Central Time).
Attn: Consumers Department
14002 E. 21st Street, Suite 1200
Tulsa OK 74134