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




03-28-2018

After it self-disclosed conduct to OIG, Allen’s Nursing Home, d/b/a South Kingstown Nursing and Rehabilitation Center (SKNRC), Rhode Island, agreed to pay $42,734.62 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that SKNRC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

03-27-2018

On March 27, 2018, ASAP Home Nurses, Inc. (ASAP), located in Wadsworth, Ohio, entered into a $11,406.26 settlement agreement with OIG. The settlement agreement resolves allegations that ASAP employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a state tested nurse aide, provided items or services to ASAP’s patients that were billed to Federal health care programs. Senior Counsel Keshia Thompson represented OIG with the assistance of Paralegal Specialist Eula Taylor.

03-26-2018

On March 26, 2018, Community Care, Inc. (CCI), located in Brookfield, Wisconsin, entered into a $208,585.20 settlement agreement with OIG. The settlement agreement resolves allegations that CCI, a care management organization, contracted with an individual who was excluded from participating in any Federal health care programs. OIG’s investigation revealed that the excluded individual provided for residential items or services to CCI’s patients that were billed to Federal health care programs. Associate Counsel Jonathan Culpepper represented OIG.

03-21-2018

On March 21, 2018, Pharmex Pharmacy, LLC, and Israel Weber (collectively, “Pharmex”), Lakewood, New Jersey, entered into a $314,205.76 settlement agreement with OIG. The settlement agreement resolves allegations that Pharmex employed an individual who was excluded from participating in any Federal health care programs. OIG’s investigation revealed that the excluded pharmacist provided items or services to Pharmex patients that were billed to Federal health care programs. Associate Counsel Srishti Sheffner represented OIG.

02-13-2018


On February 13, 2018, Southwest Trinity Management, LLC (STM), entered into a $141,986.36 settlement agreement with OIG. The settlement agreement resolves allegations that STM, through a skilled nursing facility it owns and manages in Oklahoma City, Oklahoma, employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a licensed practical nurse, provided items or services that were billed to Federal health care programs.

01-23-2018

On January 23, 2018, Matthew Anderson and PMC Management Company, LLC (PMC), Tennessee, agreed to be excluded from participation in all Federal health care programs for a period of 5 years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that Anderson and PMC caused pharmacies to submit requests for payment to Part D Plan Sponsors and TennCare for medications, including controlled substances that were not dispensed for a legitimate medical purpose and/or that were dispensed without obtaining valid prescriptions under Tennessee law. OIG also alleged that Anderson and PMC submitted, or caused the submission of claims to Medicare that were : (1) coded with CPT code 99214 and modifier -25 when those claims were not payable as such; and (2) provided by a nurse practitioner who was not collaborating with a physician as required by Tennessee law. Senior Counsel Andrea Treese Berlin represented OIG.

After it self-disclosed conduct to OIG, Miller Holdings Sunrise, Inc. d/b/a Sunrise Homes (Sunrise Homes), Ohio, agreed to pay $15,815.88 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Sunrise Homes employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

01-17-2018

After it self-disclosed conduct to OIG, Wahiawa General Hospital (Wahiawa), Hawaii, agreed to pay $100,000 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Wahiawa employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

01-05-2018

After it self-disclosed conduct to OIG, St. Agnes Healthcare, Inc. (St. Agnes), Maryland, agreed to pay $2,231,722.50 for allegedly violating the Civil Monetary Penalties Law, including provisions applicable to physician self-referrals and kickbacks. OIG alleged that St. Agnes paid remuneration to a physician in the form of excessive compensation that included an inflated salary and improper incentive and administrative payments.

01-03-2018

After it self-disclosed conduct to OIG, East Tennessee Personal Care Services, LLC (ETPCS), Tennessee, agreed to pay $85,131.56 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that ETPCS employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

12-29-2017

On December 29, 2017, Turtle Creek Recovery Center (Turtle Creek), Dallas, Texas, entered into a $24,428.58 settlement agreement with OIG. The settlement agreement resolves allegations that Turtle Creek employed an individual who was excluded from participating in any Federal health care program. OIG’s investigation revealed that the excluded individual, a counselor, provided items or services to Turtle Creek’s patients that were billed to Federal health care programs. Deputy Branch Chief Nicole Caucci represented OIG with the assistance of Paralegal Specialist Eula Taylor.

12-12-2017

After they self-disclosed conduct to OIG, Meriwether Healthcare, LLC d/b/a Warm Springs Medical Center and Warm Springs Nursing Home (collectively, “Warm Springs”), Georgia, agreed to pay $253,398.32 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Warm Springs 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, Friendly Medical Transportation, LLC (FMT), North Carolina, agreed to pay $54,812.25 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that FMT employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

12-06-2017

After it self-disclosed conduct to OIG, HVL Corp d/b/a The Whittier Pavilion (Whittier), Massachusetts, agreed to pay $51,021 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Whittier employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

12-04-2017

On December 4, 2017, Dr. Sherry Ma (Dr. Ma), a neurologist in Saint Louis, Missouri, 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) for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Dr. Ma received vials of Botox® and Myobloc® (Medications) at no charge that were supposed to be used for specific patients with private insurance. Instead of discarding the reminder of the Medications contained within vials labeled as single-dose vials, Dr. Ma kept and stored the remainder in excess of 24 hours. Subsequently, Dr. Ma used the remaining portion of the Medications on Medicare patients but submitted claims for payment to Medicare as if she had purchased new vials. Senior Counsel David Fuchs represented OIG.

12-01-2017

After they self-disclosed conduct to OIG, Kennon Stuart Legacy Trusts and the QTIP Trust, through its companies Victoria Special Care Center, Inc. d/b/a Shea Family Care Victoria and Magnolia Special Care Center, Inc. d/b/a Shea Family Care Magnolia (collectively, “Shea Family Care”), California, agreed to pay $399,700.45 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Shea Family Care employed two individuals that it knew or should have known were excluded from participation in Federal health care programs.

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.

11-03-2017

After it self-disclosed conduct to OIG, EyeCare Associates of East Texas (ECA), Texas, agreed to pay $13,562.40 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that ECA 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