OIG Check - Office Of Inspector General
An OIG Check refers to a review or screening process conducted to determine whether an individual or entity has been excluded, suspended, or otherwise deemed ineligible to participate in federal healthcare programs. The term “OIG” stands for the Office of Inspector General.
The Office of Inspector General (OIG) is a component of the U.S. Department of Health and Human Services (HHS) responsible for overseeing and ensuring the integrity of federal healthcare programs. One of its crucial functions is to maintain a list of individuals and entities that have been excluded from participating in programs such as Medicare and Medicaid due to various reasons, including convictions for healthcare fraud or patient abuse, licensing board actions, and defaulting on Health Education Assistance Loans.
An OIG Check involves searching the OIG’s List of Excluded Individuals and Entities (LEIE) to verify whether a person or entity is excluded from participation in federal healthcare programs. This check is essential for healthcare providers, organizations, and institutions that receive federal healthcare funding or reimbursement, as they are required by law to ensure that they do not employ or contract with individuals or entities on the OIG exclusion list.
The key purposes of an OIG Check are:
- Compliance: To ensure compliance with federal healthcare program requirements and regulations.
- Preventing Fraud and Abuse: To prevent individuals or entities that have committed healthcare fraud, patient abuse, or related offenses from participating in federal healthcare programs.
- Protecting Patient Safety: To safeguard patient safety by identifying and excluding individuals or entities with a history of harmful actions or offenses.
Conducting an OIG Check is a standard practice in the healthcare industry to protect the integrity of federal healthcare programs and to maintain legal and ethical standards. It is typically carried out during the hiring process for healthcare employees, as well as periodically for ongoing compliance. Many healthcare organizations use software solutions or services that provide automated OIG screening to ensure the ongoing exclusion status of employees and contractors.
