Why is compliance monitoring required? This is a question that has likely crossed the mind of anyone working in compliance, but it’s also one that’s likely not pondered in much detail. Afterall, the “why?” is pretty easy to figure out, because the Office of the Inspector General (OIG) gives healthcare organizations guidelines for compliance monitoring. So rather than looking at the “why?” for compliance monitoring, let us instead look at “what if?”. What happens if compliance monitoring runs behind and someone slips through the cracks and your organization ends up hiring someone that is on the OIG Exclusion list?
So far in 2023, 17 different healthcare organizations have agreed to pay a total of $2.3 million dollars in settlements to the Office of the Inspector General (OIG) for employing individuals that have been excluded from participating in any Federal health care programs. Out of those 17 healthcare organizations, 8 were hit with settlements above $100,000 by the Office of the Inspector General (OIG) just for employing excluded individuals, and in January 2023, Dignity Health Medical Group settled with the OIG for $338,000, all for employing excluded individuals. In addition to those numbers, the settlements paid to the Office of the Inspector General (OIG) do not take into account whether those individuals were excluded by other federal or state agencies, which can often be the case and would carry their own separate penalties as well.
OIG Compliance Monitoring with Vālenz® Health
At Vālenz® Health, we’re committed to a strong, vigorous, and healthy vision of healthcare, and OIG compliance monitoring is an important part of that vision. Our product, EPStaffCheck, can help ensure your compliance monitoring program remains top notch by allowing you to monitor sanction and exclusion lists like the OIG Exclusion List, SAM, and all of the available state Medicaid databases all at once. EPStaffCheck will allow you to monitor your providers, staff, and vendors against sanction and exclusion lists to catch any possible compliance issues to ensure your organization does not end up on the wrong side of a settlement with the Office of the Inspector General (OIG).