HR managers have admitted that they lose at least 14 hours of time per week on manual hiring and background check processes. Time-intensive manual processes cannot keep up with the growing needs of healthcare organizations or the regulatory shifts within the healthcare industry. This is only one reason that HR professionals are choosing more efficient options to alleviate administrative burdens.
The Department of Health and Human Services’ Office of Inspector General (OIG) maintains a List of Excluded Individuals and Entities (LEIE). The individuals and entities on the list are excluded from participation in federal healthcare programs because they have committed a crime, such as Medicare or Medicaid fraud, or have engaged in other misconduct. States maintain their own exclusion lists for their Medicaid programs. Manually searching through multiple exclusion lists and verifying potential matches can be time-consuming and cause errors. With an automated approach (using software that searches multiple lists at once) toward exclusion list checks, organizations can cut down on wasted time, reduce the likelihood of preventable errors, and streamline their overall compliance workflow.
Why It Is Essential to Conduct an OIG Search to Complement a Background Check
What is an OIG search on a background check? Overall, an OIG criminal background check process in healthcare (searching the List of Excluded Individuals and Entities for specific individuals or entities that you may hire, or have already hired to see if they are on the list) helps mitigate risks for the hiring organization and the portions of the public they serve. It identifies individuals and entities that have been excluded from participating in federally funded healthcare programs.
The OIG maintains the List of Excluded Individuals/Entities (LEIE), and those who are listed are barred from receiving payment from programs such as Medicare and Medicaid. The list reveals the basis of an exclusion. Many if not most exclusions result from an entity or individual’s having engaged in criminal activity, such as:
- offenses related to the delivery of items or services under Medicare or Medicaid;
- felony convictions for healthcare-related fraud, theft, or other financial misconduct; and
- felony convictions relating to unlawful manufacture, distribution, prescription, or dispensing of controlled substances.
When performing an OIG search on a background check, you are essentially ensuring that the individuals you’re hiring or the vendors you are contracting with have not been involved in incidents related to fraud, patient abuse, or any criminal activity that could disqualify them from participating in federal healthcare programs.
An OIG search background check is an essential start to your vetting process because it will ultimately enhance quality patient care and safety and protect your business from hefty fines.
How to Cut Down Wasted Time From Your Vetting Process
An efficient vetting process is essential for healthcare businesses to ensure compliance and consistently maintain operational integrity. Background checks can take several days to complete, if you are conducting the check by searching an actual list populated with the names of excluded individuals and entities. A number of factors result in “manual” background checking being a time-intensive process. These include:
- The type of background check you’re conducting
- Checking multiple exclusion lists against the person or vendor
- Lists containing inaccurate or non-current information
- The mobility and past operational coverage of the potential employee or vendor
Manually checking each candidate or vendor across multiple exclusion lists, one by one, can slow down your hiring and contracting workflows. This is one reason to opt for a compliance software solution that can check against at least 55 exclusion lists, including lists specific to the state(s) where you are hiring.
Your organization can take actionable steps to cut down on wasted time during your vetting process by leveraging compliance software.
Start Automating Your Background Checks Across Exclusion Lists
Checking multiple lists, one by one, can cause HR departments to waste a significant amount of time. This kind of checking is challenging, as lists populated with the names of individuals and entities may be inaccurate or contain incomplete information.
To decrease the chance of confusion and administrative burden, more professionals are actively seeking solutions that eliminate the need for manual data entry and cross-referencing.
Prioritize Setting Up Automated Alerts for Potential Matches
Not all compliance software options are designed the same, which is why it’s essential to seek out certain features such as real-time alerts. The right compliance software is going to easily satisfy your business’s fluctuating hiring needs by flagging potential exclusion list matches for you. This type of feature makes it likely that a hit on an OIG criminal background check is a true match.
Opt for a Centralized Compliance Dashboard
Managing the vetting process through a centralized compliance dashboard allows businesses to access all exclusion search data in one place. Having access to a centralized platform will allow for:
- Scalability across your departments as you grow
- Actionability (ensuring excluded individuals or entities are not hired or retained)
- Automation of what should be a continuous monitoring process
The right type of compliance software will offer report compilation, track the status of each check, and provide regular updates in case something changes after an initial check.
Choosing the Right Solution for Your Organization
Juggling multiple systems or paper records and having to manually check exclusion lists isn’t an effective way to vet your business relationships.
Using the right type of compliance software can ultimately streamline your workflows and improve operational efficiency. When asking, “What is an OIG search on a background check?” and the best ways to approach it, consider how much time, money, and resources this check saves you, and then consider how much additional time you can reclaim by streamlining your exclusion list checks.
