Re: {Healthcare Technology Alliance}, Free access to the OIG Excluded list

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Raj Nukala

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Apr 7, 2008, 11:20:05 PM4/7/08

to techal...@googlegroups.com

What is it about "Not an Honest Inquiry" ? While one can check for a person or individual's existence on the list by visiting Office of Inspector General, present day companies do it manually and few companies have automated it It is still a tedious manual process.I am trying to identify any and all scenarios which require automation which improve productivity or increase ROI for any their automation efforts. One such scenario could be to identifing a claim/prescription as being submitted by a provider on the oig list before approving such claim or prescription .. I am not aware if prescription prior authorizations take into account OIG exclusion list , like wise do the diagnostic companies check the OIG list before diagnosing the sample ? There are several lists which companies have to utilize to be compliant , ex SDN List , etc.. All I am trying to do is to get an insight into what processes or scenarios call for OIG exclusion list check .. as I am part of a company which offers web services based search that can be integrated into applications with just a few lines of code ..

Thanks
Raj

----- Original Message ----
From: Marshall Maglothin <mmagl...@medaxiom.com>
To: techal...@googlegroups.com
Sent: Monday, April 7, 2008 10:30:21 PM
Subject: {Healthcare Technology Alliance}, Free access to the OIG Excluded list

Well, I suspected this was not an honest inquiry, but some kind of promo.

The weblink I provided is the FREE, OFFICAL, U.S. OIG site:

http://oig.hhs.gov/fraud/exclusions.html

and any large healthcare organization that I have ever encountered simply checks new employees as they hire them.

Being “excluded” after being hired is certainly not something that a current employee could hide from the employing organization.

From: techal...@googlegroups.com [mailto:techal...@googlegroups.com] On Behalf Of snuf...@aol.com
Sent: Monday, April 07, 2008 9:16 PM
To: techal...@googlegroups.com
Subject: {Healthcare Technology Alliance}, Re: OIG and Integration

I am aware of a company that for a fee has automated and will undertake a review process of those vendors, new employees, current employees, doctors, etc. that may be on this list if anyone is interested.

Regards,

Alan

-----Original Message-----
From: Marshall Maglothin <mmagl...@medaxiom.com>
To: techal...@googlegroups.com
Cc: rajn...@yahoo.com
Sent: Sun, 6 Apr 2008 11:41 am
Subject: {Healthcare Technology Alliance}, Re: OIG and Integration

In the U.S., all healthcare providers who do business with DHHS CMS, that is

bill for services to Medicare, Medicaid, Tricare, Retired Railroad, etc or

as you noted are engaged in research that receives any Federal funding, are

required to verify that ALL employees (physicians, RNs, clerks, dietary

aides: ALL) are not on the OIG excluded list.

http://oig.hhs.gov/fraud/exclusions.html

This is fairly fool-proof for physicians since they not only have to be

checked by their malpractice insurer, but are also "credentialed" by each

hospital and every insurance plan -all of whom are required to check the

list and, by contract, and report any excluded provider to the other

parties.  All insurance companies' contracts require that they immediately

drop (not pay) any excluded physician.

For all other employees, the process is very simple: at the time of

employment, the person's name is checked against the OIG list which can

either be downloaded or checked on-line:  http://exclusions.oig.hhs.gov/

I print a copy of my search for the name when it returns "not found" and

drop it in the new employee's personnel file for compliance documentation.

-----Original Message-----

From: techal...@googlegroups.com [mailto:techal...@googlegroups.com]

On Behalf Of Raj Nukala

Sent: Friday, April 04, 2008 12:13 PM

To: techal...@googlegroups.com

Subject: {Healthcare Technology Alliance}, OIG and Integration

Hello All

I am interested to know how present day hospitals are using or integrating

OIG compliance check. Any companies performing clinical trials are also

using OIG Exclusion to not do business with any one on this list ?

Appreciate if anyone can share with me the scenarios which call for OIG

exclusion list check.

Regards

Raj

____________________________________________________________________________

________

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Mark Singleton

unread,

Apr 8, 2008, 10:12:16 AM4/8/08

to Healthcare Technology Alliance

Interesting thought on making a Prescriber on the OIG list, be forced
to do a PA. I have seen where PA are doubled reviewed for this, or
just totally making the prescriber off limits, but never just making
them get a double check on every claim. Very Interesting....

Mark Singleton, CPHIMS

On Apr 7, 9:20 pm, Raj Nukala <rajnuk...@yahoo.com> wrote:
> What is it about "Not an Honest Inquiry" ? While one can check for a person or individual's existence on the list by visiting Office of Inspector General, present day companies do it manually and few companies have automated it It is still a tedious manual process.I am trying to identify any and all scenarios which require automation which improve productivity or increase ROI for any their automation efforts. One such scenario could be to identifing a claim/prescription as being submitted by a provider on the oig list before approving such claim or prescription .. I am not aware if prescription prior authorizations take into account OIG exclusion list , like wise do the diagnostic companies check the OIG list before diagnosing the sample ? There are several lists which companies have to utilize to be compliant , ex SDN List , etc.. All I am trying to do is to get an insight into what processes or scenarios call for OIG exclusion list check .. as I
> am part of a company which offers web services based search that can be integrated into applications with just a few lines of code ..
>
> Thanks
> Raj
>
>
>
> ----- Original Message ----
> From: Marshall Maglothin <mmaglot...@medaxiom.com>
> To: techal...@googlegroups.com
> Sent: Monday, April 7, 2008 10:30:21 PM
> Subject: {Healthcare Technology Alliance}, Free access to the OIG Excluded list
>

>

> Well, I suspected this was not an honest inquiry, but some kind
> of promo.
>
> The weblink I provided is the FREE, OFFICAL, U.S. OIG site:
> http://oig.hhs.gov/fraud/exclusions.html
> and any large healthcare organization that I have ever
> encountered simply checks new employees as they hire them.
>
> Being "excluded" after being hired is certainly not
> something that a current employee could hide from the employing organization.
>
> From:techal...@googlegroups.com [mailto:techal...@googlegroups.com] On
> Behalf Of snuff...@aol.com
> Sent: Monday, April 07, 2008 9:16 PM
> To: techal...@googlegroups.com
> Subject: {Healthcare Technology Alliance}, Re: OIG and Integration
>

> I am aware of a company thatfor a fee has automated and will undertake a review process of thosevendors, new employees, current employees, doctors, etc. that may be on thislist if anyone is interested.

>
> Regards,
>
> Alan
>
> -----Original Message-----
> From: Marshall Maglothin <mmaglot...@medaxiom.com>
> To: techal...@googlegroups.com
> Cc: rajnuk...@yahoo.com
> Sent: Sun, 6 Apr 2008 11:41 am
> Subject: {Healthcare Technology Alliance}, Re: OIG and Integration
> In the U.S., all healthcare providers who do business with DHHS CMS, that isbill for services to Medicare, Medicaid, Tricare, Retired Railroad, etc oras you noted are engaged in research that receives any Federal funding, arerequired to verify that ALL employees (physicians, RNs, clerks, dietaryaides: ALL) are not on the OIG excluded list. http://oig.hhs.gov/fraud/exclusions.html This is fairly fool-proof for physicians since they not only have to bechecked by their malpractice insurer, but are also "credentialed" by eachhospital and every insurance plan -all of whom are required to check thelist and, by contract, and report any excluded provider to the otherparties. All insurance companies' contracts require that they immediatelydrop (not pay) any excluded physician. For all other employees, the process is very simple: at the time ofemployment, the person's name is checked against the OIG list which caneither be downloaded or checked on-line:
> http://exclusions.oig.hhs.gov/ I print a copy of my search for the name when it returns "not found" anddrop it in the new employee's personnel file for compliance documentation. -----Original Message-----From: techal...@googlegroups.com [mailto:techal...@googlegroups.com]On Behalf Of Raj NukalaSent: Friday, April 04, 2008 12:13 PMTo: techallia...@googlegroups.comSubject: {Healthcare Technology Alliance}, OIG and Integration Hello All I am interested to know how present day hospitals are using or integratingOIG compliance check. Any companies performing clinical trials are alsousing OIG Exclusion to not do business with any one on this list ?Appreciate if anyone can share with me the scenarios which call for OIGexclusion list check. RegardsRaj ___________________________________________________________________________-_________You rock. That's why Blockbuster's offering you one month of BlockbusterTotal Access, No Cost.
> http://tc.deals.yahoo.com/tc/blockbuster/text5.com
>

> Get the MapQuest
> Toolbar, Maps, Traffic, Directions & More!
>

> ___________________________________________________________________________-_________
> You rock. That's why Blockbuster's offering you one month of Blockbuster Total Access, No Cost. http://tc.deals.yahoo.com/tc/blockbuster/text5.com- Hide quoted text -
>
> - Show quoted text -

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