Healthcare Sanctions Check.

A healthcare sanctions check is a thorough examination of an individual healthcare provider's background to determine if they have been sanctioned or disciplined by federal agencies. These agencies can include the Office of the Inspector General (OIG), the General Services Administration (GSA), state licensing boards, and other federal government agencies.

This check is crucial for healthcare organizations to ensure they are not hiring or contracting with individuals who have been involved in fraudulent activities or unethical behavior in the past. A healthcare sanctions check helps maintain the integrity of your healthcare system and protects patients from potential harm.

Healthcare sanctions screening is specifically designed to meet regulatory requirements in the healthcare industry. While standard background checks typically focus on criminal history and employment verification, healthcare sanctions checks examine exclusion lists, disciplinary actions, and license restrictions that could affect Medicare/Medicaid participation. This specialized screening helps healthcare organizations maintain compliance with federal regulations and avoid costly penalties.

Healthcare sanctions checks should be conducted regularly, ideally at least once a year for ongoing healthcare providers. Additionally, checks should be performed whenever there is a change in employment status or when there are concerns about an individual's conduct or qualifications.

While organizations can manually search individual databases, this approach is time-consuming and risks missing critical information. Professional healthcare sanctions screening services provide comprehensive database coverage, automated monitoring, and detailed documentation that helps demonstrate compliance efforts. This systematic approach reduces administrative burden while ensuring thorough compliance screening.

Healthcare sanctions or disciplinary actions can result from various actions, including but not limited to fraud, patient abuse or neglect, substance abuse, criminal convictions, and violations of licensing laws or regulations.

It is essential for healthcare organizations to screen for these actions to maintain the highest standards of patient care and safety.

Employment of excluded providers can result in significant financial penalties, including Civil Monetary Penalties of up to $10,000 per item or service provided by the excluded individual. Organizations may also face Medicare/Medicaid payment denials, corporate integrity agreements, and potential False Claims Act liability. Regular sanctions screening helps prevent these costly compliance violations.

Continuous monitoring provides real-time alerts when new sanctions or exclusions are published, allowing organizations to respond promptly to compliance issues. This proactive approach helps maintain ongoing compliance between regular screening intervals and demonstrates a commitment to compliance program effectiveness.