For healthcare organizations, compliance monitoring is vital to identify and prevent fraud as well as to ensure patient safety. However, exclusion monitoring is complicated by the myriad of sources that need to be monitored consistently and the fact that data is published at varying intervals and in multiple formats.
The two major federal sources that need to be screened for exclusions are the Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) and SAM.gov. Healthcare organizations are required to screen against these at a minimum monthly. And, to ensure your patients aren't seen by excluded providers, it's essential to have a reliable process to identify when updates are made to the primary sources. Read on to learn more about recent and upcoming changes to SAM.gov and to the OIG LEIE.
Recent SAM.gov Site Overhaul
The SAM.gov database launched in 2012, formed under a mandate of the Affordable Care Act to create one broader dataset of individuals and entities that are debarred, sanctioned, or excluded from doing business under a federal contract. SAM stands for the System for Award Management and includes several federal contracting databases (including USDA-FNS, TREAS-OFAC, OPM, HHS and more).
On May 24, 2021, SAM.gov rolled out a brand new user interface and a reorganization of the site. According to SAM.gov, their updates "incorporate customer-focused functionality changes, to improve the overall experience for site visitors." The changes to the search functionality include, but aren't limited to:
- Streamlined advanced search experience.
- Advanced filters are now on the same page as the search results, making it easier to adjust the filters without starting a new search.
- Filters are now displayed in an easy-to-use list, making the search option easily accessible and expandable.
Need help navigating these changes? Check out ProviderTrust's one-pager with some helpful tips and tricks for when you're utilizing the new site.
Currently, we are working on how to search for a business using its Employer Identification Number. Updated navigation instructions will be coming soon!
Coming Soon: OIG LEIE Modernization
The OIG LEIE is the main primary source to be monitored for exclusions, consisting of individuals and entities that have been excluded from participating in federal healthcare programs. During the OIG's keynote session at the virtual HCCA Compliance Institute in April, they shared their top 10 compliance priorities for 2021, including their efforts to modernize the LEIE. Specifically, the OIG will be seeking feedback in the near future from healthcare industry stakeholders on how to modernize the format and delivery of various published guidance and resources, including the LEIE, which gets 26 million visits on an annual basis. The OIG is considering how to adopt modern data sharing practices for this list, including APIs, to ensure easier access, a compliance industry trend we are leading at ProviderTrust . Ultimately, the OIG's efforts to modernize center around making the data and information they provide more readily accessible and usable to the healthcare industry.