OIG Exclusion Screening

OIG Exclusion Screening.

STREAMLINED.

AUTOMATED UPDATES

Eliminate exclusion slip-ups for good. Streamline Verify automatically searches every employee, every month, notifying you of all new potential matches.

GUARANTEED COMPLIANCE

Fail-safe; foolproof. Our screening process includes all federal and state exclusion databases, going over and above OIG requirements.

PEACE OF MIND

We guarantee nothing less than 100% OIG compliance with our automated OIG Exclusion List screening. Our liability. Our responsibility. Our promise.

OIG EXCLUSION SCREENING’S MOST EFFECTIVE SOFTWARE…

BECAUSE COMPLIANCE SHOULD NEVER BE LEFT TO CHANCE.

RECENT OIG PENALTIES AND AFFIRMATIVE EXCLUSIONS




03-13-2017

On March 13, 2017, Elizabeth Kressin, D.C. (Kressin), an Iowa chiropractor, agreed to be excluded from participation in Federal health care programs for a period of three years under 42 U.S.C. § 1320a-7(b)(7) for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Kressin caused claims to be submitted to Iowa Medicaid for chiropractic services performed on children, which were not provided as claimed and were for treatment of conditions for which payment is not allowed under applicable rules. Associate Counsel Jennifer Leonardis represented OIG.

03-08-2017

On March 8, 2017, Dr. Vinod Sharma, (Dr. Sharma) a Michigan physician and pain management specialist, agreed to be excluded from participation in Medicare and the State health care programs for a period of three years under 42 U.S.C. § 1320c-5 following a referral to OIG by Kepro, the Beneficiary and Family Centered Care Quality Improvement Organization (QIO). OIG’s investigation determined that Dr. Sharma substantially violated the obligation to provide services (1) of a quality that met professionally recognized standards of health care, and (2) that were supported by evidence of medical necessity and quality in such form and fashion and at such time as was reasonably required by the QIO in the exercise of its duties and responsibilities. Specifically, OIG alleged that Dr. Sharma failed to sufficiently document his response to the results of urine drug screenings and any discussions he had with patients regarding the urine drug screening results when these patients (1) tested positive for illicit drugs; (2) tested positive for controlled substances Dr. Sharma did not prescribe; (3) tested positive for noncontrolled substances Dr. Sharma did not prescribe; or (4) tested negative for controlled substances Dr. Sharma prescribed. Senior Counsel Kristen Schwendinger, Senior Counsel Geoffrey Hymans and Associate Counsel Srishti Sheffner represented OIG.

02-16-2017

After it self-disclosed conduct to OIG, Athena Orchard View LLC d/b/a Orchard View Manor (Orchard View), Rhode Island, agreed to pay $61,576.22 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Orchard View employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

02-08-2017

After it self-disclosed conduct to OIG, OhioHealth Corporation (OhioHealth), Ohio, agreed to pay $231,277.60 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that OhioHealth employed three individuals that it knew or should have known were excluded from participation in Federal health care programs.

02-06-2017

After it self-disclosed conduct to OIG, Health Sciences, Inc. (Health Sciences), Alabama, agreed to pay $10,000 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Health Sciences employed two individuals that it knew or should have known were excluded from participation in Federal health care programs.

02-01-2017

After it self-disclosed conduct to OIG, Ridgeview Institute, Inc. (Ridgeview), Georgia, agreed to pay $29,113.82 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Ridgeview employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

01-30-2017

After it self-disclosed conduct to OIG, Ocean Dental of Arkansas, PC (ODA), Arkansas, agreed to pay $17,346 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that ODA employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

01-13-2017

On January 13, 2017, in connection with the resolution of his False Claims Act liability, Dr. Sotero Ureta, Lake City, Michigan, agreed to be excluded from participation in all Federal health care programs for a period of three years under 42 U.S.C. § 1320a-7(b)(7). OIG’s investigation revealed that Dr. Ureta caused the submission of false claims to Medicare and Medicaid for physical therapy, electrodiagnostic testing, and/or home health care services that he referred in exchange for illegal remuneration or kickbacks. Senior Counsel David Traskey represented OI

01-11-2017


Roben Brookhim, an unlicensed Dentist in New Jersey, agreed to pay $1,134,000 for allegedly violating the Civil Monetary Penalties Law and agreed to be excluded from participation in Federal health care programs for a period of fifty years under 42 U.S.C. § 1320a-7a and 42 U.S.C. § 1320a-7(b)(7). OIG alleged that Brookhim owned, controlled, and managed Associated Dental NP, LLC (ADNP), a New Jersey dental practice with multiple locations, in violation of his exclusion from Federal health care program participation in August 2000. OIG further alleged that as part of his fraud scheme, Brookhim assumed the identity of a licensed New Jersey dentist (Dentist A), to provide services to ADNP patients. Brookhim assumed Dentist A’s identity because Brookhim’s license to practice dentistry was suspended in 1999 and revoked in 2004. OIG contends that Brookhim presented claims for services to various New Jersey Medicaid Managed Care Organizations identifying Dentist A as having providing services; in fact, Dentist A never rendered services to ADNP patients. Brookhim continued to pose as Dentist A and submit claims in his name — even after Dentist A died. Senior Counsels David Blank and Michael Torrisi represented OIG with the assistance of Paralegal Specialist Mariel Filtz.
News Release

01-06-2017

On January 6, 2017, Deseret Health Group and Jon Robertson (Robertson), Bountiful, Utah, agreed to be excluded from participation in all Federal health care programs for a period of thirty years under 42 U.S.C. §§ 1320a-7(b)(7) and 1320a-7(b)(6)(B). OIG alleged that Deseret Health Group and Robertson: (a) failed to provide adequate care planning and assessments of residents; (b) failed to provide medications, treatments, laboratory tests, physical therapy, and other services as ordered and/or prescribed by residents’ physicians; (c) failed to properly use and/or administer psychotropic drugs; (d) failed to follow appropriate pressure ulcer and infection control protocols for some residents; (e) failed to follow appropriate fall protocols for some residents; (f) failed to properly administer medications to some of the residents to avoid medication errors; (g) failed to provide a safe living environment for residents; and (h) failed to answer some residents’ call lights promptly. Senior Counsel Felicia Heimer represented OIG.

A NECESSARY ADDITION TO EVERY COMPLIANCE OFFICER &
HR COORDINATOR’S EXCLUSION SCREENING TOOLKIT

THE SOFTWARE BUILT BY HR PEOPLE, FOR HR PEOPLE.

Streamline Verify is the effective and affordable solution that keeps your company OIG compliant, WITHOUT the tedious, labor-intensive data input requirements. Our automated OIG Exclusion List will save you time and money and make sure you stay compliant without any difficulty. Learn more about our hassle-free OIG Exclusion Screening software and discover how simple OIG compliance can be with Streamline Verify.

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TESTIMONIALS

  • “We’re delighted by how easily Streamline Verify has become an integral part of our operations. Our confidence levels in our screening have never been higher and our alert resolution processing has been enhanced dramatically. Plus, the learning curve is virtually non-existent – our staff has been comfortable using Streamline Verify since Day 1.” C. Joseph Kurland, Esq
  • “The “can do” attitude of the service and technical staffs at Streamline is truly remarkable. Streamline quickly adapted Streamline Verify to easily process the expanded number of uploads we required with a focus and a commitment to excellence that produced results and exceeded our expectations.” Cheri A. Copie, BSN, CHC, Director of Compliance and Regulatory Affairs NeoGenomics Laboratories