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




11-06-2017

On November 6, 2017, Diamonds & Pearls Health Services, LLC (DPHS), Cleveland, Ohio, entered into a $75,471.92 settlement agreement with OIG. The settlement agreement resolves allegations that DPHS employed an individual who was excluded from participation in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a scheduling/staffing coordinator, provided items or services to DPHS patients that were billed to Federal health care programs.

On November 6, 2017, Center for Ear, Nose Throat & Allergy, P.C. (CENTA), Carmel, Indiana, entered into a $51,564.14 settlement agreement with OIG. The settlement agreement resolves allegations that CENTA employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a medical records file clerk, provided items or services to CENTA’s patients that were billed to Federal health care programs. Associate Counsel Srishti Sheffner represented OIG with the assistance of Paralegal Specialist Jennifer Hilton.

10-24-2017

On October 24, 2017, Prohealth Neurodiagnostic, Inc., an independent diagnostic testing facility in Van Nuys, California, and Arsen Oganesyan, its owner (collectively, “Prohealth”), agreed to be excluded for a period of five years under 42 U.S.C. § 1320a-7(b)(7). OIG’s investigation revealed that Prohealth submitted claims for nerve conduction studies that are considered screening exams and not covered by Medicare, in violation of a Local Coverage Determination governing the medical necessity of such studies. OIG’s Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsels Geoffrey Hymans and Kenneth Kraft, collaborated to achieve this resolution.

10-19-2017

On October 19, 2017, in connection with the resolution of its False Claims Act liability, Total Lab Care, LLC (Total Lab Care), Jacksonville, Florida, agreed to be permanently excluded from participation in all Federal health care programs under 42 U.S.C. § 1320a-7(b)(7). OIG’s investigation revealed that Total Lab Care knowingly billed Federal health care programs for urine toxicology samples that were not reimbursable. Specifically, OIG alleged that Total Lab Care sought reimbursement for urine toxicology samples referred by a physician whom Total Lab Care paid improper financial remuneration. Senior Counsel Felicia Heimer represented OIG.

10-17-2017

On October 17, 2017, MHMR of Tarrant County (MHMR), Fort Worth, Texas, entered into a $97,869.78 settlement agreement with OIG. The settlement agreement resolves allegations that MHMR employed an individual who was excluded from participation in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a program director, provided items or services to MHMR clients who were receiving services funded by a Medicaid waiver program. Senior Counsel Keshia Thompson represented OIG with the assistance of Paralegal Specialist Eula Taylor.

10-11-2017


October 11, 2017, Shawnee Health Services (Shawnee), Carterville, Illinois, entered into a $107,761.08 settlement agreement with OIG. The settlement agreement resolves allegations that Shawnee employed an individual who was excluded from participation in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a case manager, provided items or services to Shawnee clients that were receiving services under a Medicaid waiver program.

10-10-2017

After it self-disclosed conduct to OIG, MAS Medical Staffing Corporation (MAS), Rhode Island, agreed to pay $93,703.82 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that MAS employed an individual, on a per diem basis on behalf of healthcare providers, that it knew or should have known was excluded from participation in Federal health care programs.

On October 10, 2017, The Arkansas Department of Health (ADH) entered into a $39,343.61 settlement agreement with OIG. The settlement agreement resolves allegations that ADH employed an individual who was excluded from participation in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a hospice social worker, provided items or services to patients of a community based hospice operated by ADH that were billed to Federal health care programs. Senior Counsel Keshia Thompson represented OIG with the assistance of Paralegal Specialist Eula Taylor.

09-27-2017

On September 27, 2017, in connection with the resolution of his False Claims Act liability, Dr. Dinesh Patel (Dr. Patel), Edison, New Jersey, agreed to be excluded again from participation in all Federal health care programs for a period of five years under 42 U.S.C. § 1320a-7(b)(7). OIG’s investigation revealed that despite previously having been excluded from participation in New Jersey Medicaid on March 17, 2012, and excluded from participation in all Federal health care programs on February 20, 2014, Dr. Patel continued to provide administrative and management services to Edison Adult Medical Daycare (EAMD) in violation of the terms of his exclusion. Dr. Patel had a previous ownership interest in EAMD, which he transferred to his wife around the time of his exclusion from New Jersey Medicaid. Senior Counsel David Fuchs represented OIG.

09-22-2017

On September 22, 2017, Patricia Anne Chapman (Chapman), Liberty Lake, Washington, agreed to be excluded from participation in all Federal health care programs for a period of 10 years under 42 U.S.C. § 1320a-7(b)(7). OIG’s investigation revealed that, in her Clinton, Iowa, podiatric practice, Chapman submitted false or fraudulent claims to Medicare using Current Procedural Terminology Code 97032: (1) for electrical stimulation services (e-stim) that were not medically reasonable or necessary, (2) for e-stim services not administered with “constant attendance” and “manual application,” according to the requirements of the code, (3) for twice the number of e-stim units than documented in the beneficiaries’ patient files, and (4) for using false records and statements to support the false e-stim claims. Senior Counsel Keshia Thompson represented OIG.

09-18-2017

On September 18, 2017, Century Pharmacy (Century), Brooklyn, New York, entered into a $10,000 settlement agreement with OIG. The settlement agreement resolves allegations that Century employed an individual who was excluded from participating in any Federal health care programs. OIG’s investigation revealed that the excluded individual, who assisted in filling prescriptions in addition to performing other clerical tasks, provided items or services to Century patients that were billed to Federal health care programs. Senior Counsel Kenneth Kraft represented OIG with the assistance of Paralegal Specialist Eula Taylor.

09-15-2017

On September 15, 2017, Sundance Behavioral Healthcare System (Sundance), Texas, entered into a $49,183.48 settlement agreement with OIG. The settlement agreement resolves allegations that Sundance employed an individual who was excluded from participating in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a licensed vocational nurse, provided items or services to Sundance patients that were billed to Federal health care programs. Deputy Branch Chief Nicole Caucci represented OIG with the assistance of Paralegal Specialist Jennifer Hilton.

09-08-2017

On September 8, 2017, Olive Sleep & EEG, Inc., an independent diagnostic testing facility, and Mariam Unjughulyan, its owner, (collectively, “Olive Sleep”) agreed to be excluded for a period of five years under 42 U.S.C. § 1320a-7(b)(7). OIG’s investigation revealed that Olive Sleep submitted claims for nerve conduction studies that are considered screening exams and not covered by Medicare in violation of a Local Coverage Determination governing the medical necessity of such studies. OIG’s Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsels Geoffrey Hymans and Kenneth Kraft, collaborated to achieve this resolution.

09-06-2017

After it self-disclosed conduct to OIG, Adventist Health System Sunbelt Healthcare Corporation d/b/a AHS Information Services (AHS), Florida, agreed to pay $101,435.28 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that AHS employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

After it self-disclosed conduct to OIG, Adventist Health System Sunbelt Healthcare Corporation d/b/a Rx Plus Pharmacy (Rx Plus), Florida, agreed to pay $15,437.12 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Rx Plus employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

09-05-2017

On September 5, 2017, in connection with the resolution of False Claims Act liability, Dr. Cory Lee Pickens, Billings, Montana, agreed to be excluded for a period of ten years under 42 U.S.C. § 1320a-7(b)(7). OIG’s investigation revealed that despite previously having been excluded from participation in all Federal health care programs on September 20, 2011, Dr. Pickens provided services to beneficiaries of the Medicaid program while he was excluded. Senior Counsel David Traskey represented OIG.

09-01-2017

After it self-disclosed conduct to OIG, Leroy R. Polite, D.M.D., P.A., d/b/a Economy Dentures and Economy Dentistry (Economy Dentures), Florida, agreed to pay $279,135 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Economy Dentures employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

 

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

  • “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
  • “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