Published On: Wed, May 19th, 2021

A Guide to Healthcare Sanctions

Healthcare sanctions are disciplinary actions against an entity or individual by a state license boarding. A sanction can damage an organization’s reputation, operations, and finances, and they can prohibit providers from participating in federal healthcare programs. Medical sanctions place a restriction on medical licenses and this can include revocation of the license, suspension, or other penalties against the company that employs the sanctioned parties. To discover a health sanction, screening needs to take place during the hiring process. Not only is this necessary during the hiring process, but monthly monitoring of providers in the organization is also recommended to mitigate risk and maintain compliance. 

The Office of Inspector General (OIG) requires a sanction screening check against a list of excluded individuals. Any organization that employs or hires someone on the list could be subjected to penalties. 


Why Healthcare Sanctions?

These sanctions are designed for excluding people who have questionable backgrounds from participating in federal healthcare programs. These sanctions are actually mandated under two different sections of the Social Security Act. People generally get sanctioned after committing a violation. The most common violations are Medicaid and Medicare fraud and patient neglect or abuse. People can also have sanctions if their license has been revoked or suspended. 

Why Are Healthcare Sanction Screenings Important?

A state license board may place someone on the OIG exclusion list for violations that include patient neglect or abuse, conviction of Medicaid or Medicare fraud, felony convictions related to healthcare fraud or financial misconduct, or felony convictions related to controlled substances. The consequences of employing someone who has been excluded or sanctioned can be severe. There are a number of different benefits to screening applicants. The first is improved patient safety. Sanctioned individuals may pose a risk to patients and you can reduce the chances of patient abuse or malpractice if you avoid hiring these individuals. You will also have better compliance and won’t lose the ability to participate in state and federal health programs. You will also have a lower risk of lawsuits and fines. 

What’s the Difference between Federal and State Board Exclusions?

The OIG has federal authority to exclude individuals. However, in addition to federal consequences, state medical boards are also able to take action against both an individual and an entity. A sanctioned entity or individual can have both a federal sanction and state board action. State license boards also respond to and investigate complaints and take subsequent action to publicly report disciplinary measures, to prevent individuals or entities from getting state funds for Medicaid. States also have the right to take criminal action. 

How to Avoid Hiring People with Sanctions

Since the penalties of hiring individuals with sanctions are very steep you want to make sure you take action to avoid hiring any sanctioned individuals. The best strategy to do this is with healthcare sanction checks. The checks help determine if an individual is on a sanction list. In order to make these checks effective, you may want to conduct them at least three times. 

Before Hiring: Before you hire any professional, it’s best to do a sanction check. This is the only way you can avoid hiring a sanctioned individual. 

Before Appointment: The lists are updated occasionally. There is a time-lapse between when someone appears on the list and when they are sanctioned. Due to this, the time between appointment and the time of hire means that someone could be on the list without you realizing it at first. Before you give an employee a contract, you should also do a sanction check. 

Periodically: Since the lists are updated, as part of due diligence as an employer it is important to run the names of your employees through the list. This is the only way to make sure that anyone who has slipped through can be weeded out. It’s also important to do periodic checks as healthcare regulations are always changing and expanding. Compliance is always going to be an important part of maintaining a screening program. These checks will ensure that you stay in compliance.

Working with a provider that can help you perform these healthcare sanction checks can make your hiring process more efficient. 


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About the Author

- Veselina Dzhingarova has long experience in internet marketing and SEO. She is passionate about blogging to share her expertise. Veselina is a regular contributor at many other online publishers like chamberofcommerce.com, marketoracle.co.uk, newswire.net, bizcommunity.com, socialnomics.net and more. She is the co-founder of Financia­ltipsor.co­m, cryptoe­xt.com, Bl­ogforweb.c­om, Techsu­rprise.com­, travelti­psor.com a­nd others.­ You can get in touch with her on LinkedIn , Google+ or at [email protected]

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