Long term and post-acute care providers can stay ahead of OIG and CMS scrutiny by employing two fairly simple processes:

• Require the disclosure of any exclusion, suspension, or debarment as part of the process of entering into new relationships with employees and contractors.
• Routinely check employees and contractors against the publicly available data on exclusions, suspensions, and debarments.

Providers should also consider implementing a policy that asks new and prospective employees or contractors to affirmatively disclose whether or not they currently are, or ever have been, excluded, suspended, or debarred from a federal health care program or contract, as well as whether they are currently subject to any type of judicial or administrative process that might lead to a possible exclusion, suspension, or debarment.

Providers should also confirm that the individual or entity does not appear on either of the applicable federal databases as well as any state database that may exist for Medicaid.

All individuals and entities currently employed should be screened periodically to ensure that they have not subsequently been placed on an exclusion, suspension, or debarment list.

Determining the appropriate and most efficient schedule for conducting such screenings warrants consideration. For example, if employees, on an individual basis, regularly generate significant Medicare and Medicaid revenue, the risk of finding out several months into an issue can outweigh the human and financial cost of conducting monthly screenings.

Additionally, providers should consider requiring an annual certification from employees and contractors to ensure that they are not currently, nor have they ever been, excluded, suspended, or debarred from a federal health program or contracts and that they are not currently subject to any type of judicial or administrative process that might lead to a possible exclusion, suspension, or debarment.
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