Industry Specific Inquiries - click on the name to learn more
Health Care Comply Plus ™
HEALTH CARE COMPLY PLUS ™ provides information on individual health care providers by conducting a search of the sanction information compiled by the Office of the Inspector General (OIG), the General Services Administration (GSA) and other federal agencies. The information reported meets requirements for sanction screening set forth in the OIG's Compliance Program Guidance for health care employees and contractors. The information is more thorough than only checking the OIG and GSA databases established by these governing agencies because it includes historic, as well as current, sanction data.
HEALTH CARE COMPLY PLUS ™ also conducts a search of disciplinary actions taken by federal agencies other than the OIG and GSA, including those actions taken by licensing and certification agencies in all 50 states against individual health care providers. HEALTH CARE COMPLY PLUS ™ includes CI’s Global Scan inquiry, a Patriot Act terrorist database search.
HEALTH CARE COMPLY PLUS ™ :
• Office of the Inspector General sanctions
• General Services Administration sanctions
• State licensing agency actions
• Global Scan anti-terrorist data
HEALTH CARE COMPLY PLUS ™ is the most comprehensive search available to screen health care individuals and contractors for the sanctions described above and for actions covered by the Patriot Act.
Office of Inspector General Exclusion - OIG
When Congress enacted the Health Insurance Portability and Accountability Act and the Balanced Budget Act of 1997, it expanded the federal government’s authority to combat fraudulent activities in federally financed health care programs. It is with this authority that the Department of Health and Human Services Office of Inspector General (OIG) developed and maintains the List of Excluded Individuals & Entities (LEIE).
The OIG Compliance Guidelines for health care providers and health care entities dictates that they examine the OIG List of Excluded Individuals/Entities prior to hiring or contracting with individuals or entities.
CI’s OIG EXCLUSION LIST inquiry identifies individuals and entities excluded from participation in Medicare, Medicaid and other federally financed health care programs. Subjects are examined by name and results found include specialty, exclusion type and date of exclusion.
The effect of an OIG exclusion from participating in federally financed health care programs is that no federal health care program payment may be made for any items or services: (1) furnished by an excluded individual or entity, or (2) directed or prescribed by an excluded physician. The prohibition also extends to payment for administrative and management services not directly related to patient care, but that are a necessary component of providing items and services to federally financed health care program beneficiaries.
The practical effect of an OIG exclusion is to preclude employment of an excluded individual in any capacity by a health care provider that receives reimbursement, directly or indirectly, from any federally financed health care program.
General Services Administration Exclusion - GSA
CI's General Services Administration Exclusion (GSA) inquiry instantly disseminates information on Individuals that may be excluded from such contracts and/or benefits for various violations including:
Vigilant MEDS ™
Medical Exclusions Data Search
Protecting your organization from regulatory scrutiny is critical to your ability to continue to serve your community with vital healthcare services.
Unlike our competitors, Vigilant MEDS is a FULL SERVICE sanction testing solution, that validates your employee’s, vendor’s, provider’s and volunteer’s against master - sanctioned, disbarred and excluded provider lists.
Our database contains over 200,000 records including those of the EPLS/SAM/GSA, OIG, OFAC/SDN, and all required state databases including those for New York.
Vigilant MEDS Included Basic Monthly Subscription:
Vigilant MEDS requires very little client interaction. Investigators conduct all the testing and return a detailed report of validation and when identified – potential matches. Clients simply upload their data file via our secure upload site, which is HIPAA Compliant and encrypted. Once our testing is complete, you will receive a custom and confidential report of any potential matches.
What is Vigilant MEDS?
The OIG has been clear about the need to monitor your staff, at a minimum of once per month to be compliant.
Healthcare entities are required to ensure that their employees and vendors are not sanctioned by Federal or State regulatory agencies and thus ineligible for reimbursement for services rendered under Federal and State programs. A sanctioned or excluded provider is an individual or business that has violated one more regulations and has been penalized through statutory or regulatory process from participation in a governmental program, such as Medicare or Medicaid.
How does it work?
The various regulatory agencies involved include OIG (US Department of Health & Human Services Office of Inspector General), GSA (US General Services Administration), NYS OMIG (New York State Office of the Medicaid Inspector General), and many more. These agencies each keep lists of excluded individuals and the lists are available for healthcare entities to utilize for name comparison purposes. The verification process entails two steps outlined below. Commercial Investigations LLC can assist healthcare entities with both steps or just the second step of the process. In completing both steps of the process, Commercial Investigations LLC outsources the first step of the process through a valued partnership.
Why have CI complete the process?