Medical Sanctions Screening

Medical sanctions screening is a process used by healthcare organizations, insurance companies, and regulatory bodies to ensure that individuals and entities involved in healthcare services comply with regulations and standards. This screening involves checking databases and lists of sanctioned or excluded individuals and entities, such as healthcare professionals, organizations, suppliers, and vendors, to identify any individuals or entities that may be prohibited from participating in certain healthcare programs or services due to violations, misconduct, or other reasons.

The purpose of medical sanctions screening is to protect patients, prevent fraud and abuse, maintain the integrity of healthcare programs, and uphold regulatory compliance. It helps healthcare organizations make informed decisions when hiring employees, contracting with vendors, and collaborating with other healthcare entities.

The screening process typically involves checking various databases, such as:

  1. Government databases: These include lists maintained by government agencies such as the Office of Inspector General (OIG), the General Services Administration (GSA), and state Medicaid agencies.
  2. Exclusion lists: These lists contain individuals and entities excluded from participating in federal healthcare programs, such as Medicare and Medicaid, due to reasons such as fraud, abuse, or patient harm.
  3. Licensing and credentialing databases: These databases contain information about the licensure status and disciplinary actions against healthcare professionals, such as physicians, nurses, and pharmacists.
  4. International sanctions lists: In some cases, screening may also involve checking international sanctions lists maintained by organizations such as the United Nations or the European Union.

By conducting medical sanctions screening, healthcare organizations can mitigate risks associated with non-compliance, protect their reputation, and ensure the safety and well-being of patients. It’s an essential component of healthcare compliance programs and regulatory requirements.

Contact us to learn more about medical sanctions screenings as well as inquire about our monthly monitoring program!

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