Healthcare organizations need to keep an eye on every in-and-out entity, and a sanction checks does exactly that. As a broad term, it involves a thorough background check on individuals/entities that goes beyond OIG. Including many federal and state government databases. These background verifications are broad, covering multiple government lists, for example: OIG, SAM, OFAC, FACIS, etc. The check from multiple government lists ensures that you don’t work with any entity that is involved in fraud, abuse, or illegal activity. Thereby, protects the healthcare organizations from getting scammed or working with people who can cause harm. It also protects the eligibility for federal funds.

Sanction checks are performed on individuals, vendors, and contractors to ensure that all individuals, whether employees, employers, or service providers, are safe. In this comprehensive blog post, we will explore the sanctions check, its benefits, importance, and why it is crucial for healthcare organizations.  

What are Sanction Checks?

Sanctions checks are background checks that health organizations run before working with, hiring, or signing a contract with any individual or entity. However, this list includes thousands of individuals and entities who have engaged in unethical business or professional conduct. The sanction checks are done against the list maintained by the federal and state governments. They carefully curate a database of names of people and businesses that are banned from working or pose a threat to the people they work with. 

This thorough research on sanctions checks provides a comprehensive compliance safeguard by ensuring no employee, vendor, or contractor is sanctioned, excluded, or barred from federal programs. These are the primary compliance checks that cover all necessary requirements and protect organizations from penalties. It significantly reduces the chances of financial fraud, legal penalties, and fines, and protects against reputational damage. The OIG check also maintained the list of individuals to protect against fraud, waste, and abuse while maintaining eligibility for federal reimbursements.

Various Lists Checked In Sanctions Check

Sanctions checks involve multiple lists that assess individual backgrounds based on their work to date. Here are the lists that are included in the sanctions check.

1.  OIG LEIE Check

The Office of Inspector General maintains the list of excluded entities that are not allowed to participate in any federal government programs. For example, the Medicaid and medicare programs. The OIG checks help verify whether any individual or entity is on this excluded list, so the organization can avoid working with them. Working with such an individual, vendor, or entity can expose you to financial penalties and reputational damage. However, this can be avoided through regular and accurate OIG background checks. The healthcare organisation can also ensure that it meets the eligibility criteria for federal funds such as Medicare and Medicaid.

2. SAM Check (System for Award Management)

SAM checks are performed against the U.S. government database that maintains records of entities excluded from participating in federally funded programs. It is essential for healthcare organizations, as it helps prevent them from being charged penalties and fines.

3. OFAC Check (Office of Foreign Assets Control)

OFAC stands for the Office of Foreign Assets Control, which is part of the U.S. Department of the Treasury.  This is a very strict check that helps organizations determine whether individuals are eligible to work in the United States. OFAC checks are essential to conduct before hiring any person or before you start to work with any vendors. It helps identify whether this entity is not involved in illegal activities.

4. State Medicaid & Exclusion Check

This list is maintained by state Medicaid agencies and includes individuals or entities excluded from participating in state-level work. By running this OIG exclusion check, Healthcare organizations can verify state-level exclusions and prevent themselves from engaging with providers banned from state Medicaid programs.

5. State Medical / Nursing Board License Check

This check verifies professional license validation. With the help of this list check, we can verify the active license, suspension, and any disciplinary actions. The state licensing boards maintain this list and advise against working with any entity that does not have an active license or with any entity for which disciplinary action has been taken. 

6. FACIS Check

A Fraud Abuse Control System Information (FACIS) check is conducted to obtain background information about the individual or entity. This check is performed against many government-maintained databases to assess individuals' involvement in illegal or criminal activity. The criminal activities, such as federal fraud, violent behaviour, or patient abuse.

Overview of All the Database Lists and Who Maintains Them

The different lists in the sanction check are maintained by different bodies for various purposes and ensure safety in organizations.

It’s Time To Wrap Things Up!

Sanctions checks are essential to a healthcare organization. However, it doesn’t just stick to healthcare. It also expands its uses in finance and other industries. Many national, state, and international agencies maintain lists of individuals who have ever been involved in illegal work and are not suitable to work in such sectors. Therefore, this workplace can avoid these entities by ignoring such lists. It exposes them to fines, penalties, and reputational damage. 

In the healthcare sector, patient safety is at risk if the wrong individual enters, causing harm to patients, or if a vendor that supplies poor service causes damage. The poor supply includes the medical or drug supply. However, all of this can be avoided with an automated sanction check that delivers 100% efficient results in less time. If you are looking for onelook no further than Venops.