GROUNDS FOR EXCLUSION
Failure to meet statutory obligations of practitioners and providers
Failure to meet the statutory obligation to provide services that are economical, medically necessary, of a quality meeting professionally recognised standards, and supported by adequate documentation.
What a staffing agency does with this
A quality of care exclusion under 1156 means Federal health care programmes will not pay for items or services furnished by, or at the medical direction of, the excluded party. If an excluded person is on your roster and a claim is submitted for their work, the exposure is repayment plus civil monetary penalties that accrue per claim — which is why the obligation is a recurring screening obligation, not a one-off hiring check.
Screening cadence
OIG guidance directs screening at hire and monthly thereafter, against the current published list. ExcludeRadar refreshes from the official OIG file and keeps the dated result so the cadence itself is evidenced.
Read the OIG authority reference →