They are fingerprint-based searches of state and national registries that are designed to yield more information than what you might receive from a name-based search social security record search.
HealthCare background check requirements vary depending on which organization conducts them, what the open position is, and how thorough the employer wants to be in the background check.
What to look for when running a Data Search Report
- Some of the common types of convictions that could result in a denial for a position include convictions for drug abuse, theft, elder or patient abuse, sexual offenses, and others.
- Having a strong background check policy can help you remain compliant with all relevant state and federal laws.
- Please reach out to PPS for guidance to ensure that you are ordering the correct type of Background Check for your candidate and business.
HealthCare Sanctions +
Did you know that most people in general often select their doctors based on recommendations from family and friends, HMO, or by the distance their doctor’s office is from their home? But have you ever checked to ensure that your physician or HealthCare provider hasn’t been sanctioned by a professional licensing board?
Doctors and HealthCare professionals can be disciplined for criminal convictions, medical negligence, wrongly prescribing controlled substances, and other wrongdoings.
Even with a disciplinary record, many doctors and HealthCare providers continue to practice, and some will move to another state to do so! Although hospitals have state and federal databases to look up the disciplinary histories of a doctor or health care provider, the general public cannot access them! To find out information about a doctor or health care provider the first place to start checking is the state in which they have been licensed to practice medicine. Each state, however, has a different process for looking up doctors and getting disciplinary records, if there are any. Some states provide full disciplinary histories and disclosures, including legal documents about violations and subsequent board actions. Some states may also charge a fee or require a public records form request.
If you are hiring a HealthCare provider who hires HeathCare workers, it is imperative that check your candidates for any HealthCare Sanctions.
what is a HealthCare Sanction?
Protection Plus Solutions can help provide the necessary information to ensure you are making the right hiring choices. Our HealthCare bundle(s) sanctions checks consist of multiple regulatory and governmental databases that identify individual care providers who are prohibited from working in the HealthCare industry. These sanctions may be severe such as a past criminal conviction in multiple states, or demeaning or unethical conduct for which they were disciplined in a court of law. HealthCare organizations are required under state and federal regulatory requirements to run these types of checks.
However, some individuals may be excluded from these types of checks due to a mandatory administrative sanction or a state Medicaid program. State and Federal Agencies will impose sanctions on individuals and entities when they have been found to have disregarded or posed an unacceptable risk to the hospital or agency they are working for and or the well-being and safety of the patient(s). Protection Plus Solutions HealthCare Sanctions checks are also run along with our PerfectRECORD and Unlimited data reports. (See description of both reporting information under the products page.)
OIG & SAM Exclusions Lists:
Key Components & Differences
A key operational component for any HealthCare organization’s compliance efforts is the ability to cross-check and monitor exclusions lists regularly – though in reality, this can often fall by the wayside, especially for newer digital health companies still learning the ropes.
There are two federal databases that contain persons and entities that have been barred from participating in federal HealthCare programs and receiving federal contracts for health-related services: The Office of the Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) and the General Services Administration’s (GSA) System for Award Management (SAM).
The purpose of both OIG and SAM is to prevent organizations from doing business with any party that has been debarred, sanctioned, or otherwise excluded by a federal agency.
Do State and Federal Government Agencies Require HealthCare Sanctions Screening Check?
If your company is a HealthCare provider, you are required under both state and federal laws to provide a comprehensive Background Check and HealthCare Sanctions Screening check. Failing to complete a HealthCare sanctions screening check on your employee could put your company in jeopardy of significant fines and sanctions, not to mention placing your employees and patients at risk!
Which Industries Need to Check HealthCare Sanction Lists?
Why does a HealthCare provider or company need to perform or investigate HealthCare Sanction disciplinary sanction information?
HealthCare Sanction Screening helps your business by ensuring that you are hiring qualified candidates to perform their jobs in accordance with state and federal guidelines. Also, any potential candidates you are reviewing for hire may have previously been fired or barred from working in the HealthCare arena due to neglect, patient abuse, theft, drugs, fraud, falsifying medical records, criminal activity and/or convictions, etc. You put your company, employees, and patients at risk of bad hiring by not performing a necessary and comprehensive criminal background and HealthCare sanctions screening.
Business or organizations that would benefit most from a HealthCare sanctions check include:
- Hospitals, clinics, and other major HealthCare organizations
- Private medical practice offices
- In-Home care providers
- Assisted living facilities
- Memory care facilities, such as lenders, investment firms, banks, credit unions, and brokers Volunteer Organizations who help the elderly or children.
Other business or organizations that should use these checks:
- Financial services providers
- Insurance agencies of all types
- Law firms
- Any business planning to operate internationally or transact with international customers and companies.
- Companies serving as contractors to the government.
- Businesses and the professionals in charge of regulatory compliance should speak with the appropriate legal professionals for the clearest understanding of their requirements under federal law.
The OIG, which maintains the exclusion list for the U.S. Department and Health and Human Services, keeps track of all individuals and entities currently excluded by the agency. Key information listed in the OIG’s exclusion list, updated on a monthly basis, includes:
- Name of excluded individual or entity.
- Provider type
- The authority under which the individual was excluded.
- The state residency was held at the time of the exclusion.
- Companies serving as contractors to the government.
- The importance of searching for the LEIE cannot be understated. Health providers hiring any excluded individual or entity are at risk for civil monetary penalties (CMP) for any claims submitted to a Federal program for items or services provided, directly or indirectly, by those individuals or entities. Checking the OIG exclusion list regularly can help providers avoid CMPs stemming from services provided by both current and prospective employees and contractors.
The GSA maintains the SAM to keep track of individuals and entities excluded from Federal procurement in an effort to prevent fraudulent handling of the HealthCare system and other government agencies. The following databases are captured in the SAM:
- Central Contractor Registry (CCR)
- Online Representations and Certifications Application (ORCA)
- Federal Agency Registration (Fedreg)
- Excluded Parties List System (EPLS)
If a search yields a potential hit, providers should go directly to the GSA for ultimate verification. For entities, providers need to know the Dun & Bradstreet number, while verifying an individual requires an extra four steps.
Important Operational Differences
The lists largely overlap in terms of information, but because OIG’s LEIE and GSA’s SAM exclusion lists are owned and maintained by different agencies, there are naturally distinct administrative processes. For example, the LEIE contains license information and NPI records, while the SAM does not. This can make searching for individuals in the SAM database more complicated. Additionally, the GSA does not have the authority to issue a financial penalty on an organization because it is a procurement repository – not an agency with jurisdiction.
The scope of exclusions included on OIG’s LEIEis subject to Sections 1128 and 1156 of the Social Security Act. Section 1128 covers Medicare, Medicaid, and all other Federal health care programs providing benefits funded directly or indirectly by the United States. Section 1156 extends this scope to include the state-level counterparts of Medicare and the health programs included under Section 1128. The SAM list includes debarment actions taken by a wider group of federal agencies. What type of sanctions will show up on a HealthCare Sanction Check?
HealthCare sanctions checks provide the following searches:
- DHHS OIC List of Excluded Individuals/Entities search
- General Services (GSA) System for Award Management (SAM) search
- OFAC Search (Office of Foreign Assets Control)
- State-specific exclusions/department lists
- FACIS Check (Fraud Abuse Control Information System)- FACIS background check helps identify individuals and entities with HealthCare sanctions. FACIS is made up of numerous databases with different levels of data. These databases are regularly updated to help ensure that both current employees or applications have not abused patients or engaged in fraud against the government. Protection Plus Solutions provides a Level 1 Search with our PerfectRECORD Report and a Levels 1-3 with our Unlimited Data Report. (See Products page for additional information)
- OIG LEIE Search – Office of Inspector General – LEIE database to determine whether an individual or entity has been excluded by the OIG from participating in a Federal Medicare or Medicaid program.
By partnering with Protection Plus Solutions to run your Background and HealthCare Sanction Screening you can avoid the worry of the ever-changing HealthCare regulations and compliance restrictions. Compliance should always be the MOST important aspect of your hiring guidelines. Let Protection Plus Solutions help you manage your current and future employee hiring!