Welcome to Sanction Screening Services
What is Sanction Screening Services?
S
3™ provides healthcare organizations with a robust and cost-effective screening program to manage sanctioned, excluded and high-risk individuals and entities against the U.S. Department of Health and Human Services Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE).
- Prevent prohibited transactions, with real-time, on-demand and batch screening against government databases
- Manage risks through unique filtering algorithms for individual and entity screening
- Meet requirements with S3™ flexible architecture, user friendly handling mechanisms, and on time reports
For over a decade, OIG has encouraged organizations to use screening mechanisms to avoid employing or engaging in business relationships with individuals and entities that have been convicted of criminal violations or have been subject of sanctioning, debarment, exclusion, or other adverse action that could impact on their compliance with applicable laws and regulations. If an organization employs an individual on these sanctioned lists they may be forced to pay back all Federal funds received via these programs going back to the date the person was employed. Therefore, the OIG search is vital for healthcare industries.
About the OIG Exclusion Program
For many years the Congress of the United States has worked diligently to protect the health and welfare of the nation's elderly and poor by implementing legislation to prevent certain individuals and businesses from participating in Federally-funded health care programs. The OIG, under this Congressional mandate, established a program to exclude individuals and entities affected by these various legal authorities, as contained in sections
1128 and
1156 of the
Social Security Act, and maintains a list of all currently excluded parties called the List of Excluded Individuals/Entities.
Bases for exclusion include convictions for program-related fraud and patient abuse, licensing board actions and default on Health Education Assistance Loans.
The effect of an exclusion (not being able to participate) is:
- No payment will be made by any Federal health care program for any items or services furnished, ordered, or prescribed by an excluded individual or entity. Federal health care programs include Medicare, Medicaid, and all other plans and programs that provide health benefits funded directly or indirectly by the United States (other than the Federal Employees Health Benefits Plan). For exclusions implemented prior to August 4, 1997, the exclusion covers the following Federal health care programs: Medicare (Title XVIII), Medicaid (Title XIX), Maternal and Child Health Services Block Grant (Title V), Block Grants to States for Social Services (Title XX) and State Children's Health Insurance (Title XXI) programs.
- No program payment will be made for anything that an excluded person furnishes, orders, or prescribes. This payment prohibition applies to the excluded person, anyone who employs or contracts with the excluded person, any hospital or other provider where the excluded person provides services, and anyone else. The exclusion applies regardless of who submits the claims and applies to all administrative and management services furnished by the excluded person.
- There is a limited exception to exclusions for the provision of certain emergency items or services not provided in a hospital emergency room. See regulations at 42 CFR 1001.1901(c)
Additional information is available in the
Special Advisory Bulletin on the Effect of an Exclusion.