How Do Healthcare Organizations Conduct Exclusions Screening

Exclusions screening is an essential process employed by healthcare organizations, employers, and government agencies to make sure they are not hiring or conducting business with individuals or entities that are excluded from conducting business in federally funded programs like Medicare or Medicaid. These exclusions are generally published by the Office of Inspector General (OIG) or state Medicaid agencies based on reasons such as fraud, abuse of patients, or revocation of license. Periodic running of exclusions screening ensures companies stay compliant, prevent expensive penalties, and shield their image. It entails comparing names against listings such as the OIG's List of Excluded Individuals/Entities (LEIE) and the System for Award Management (SAM). Several companies apply automatic software or hire third-party firms to simplify this process and allow regular monitoring. Effective exclusions screening is not just a regulatory obligation but also a protection to ensure ethical standards and the integrity of healthcare and other federally funded services.