Vendor Compliance

The Department of Health and Human Services Office of Inspector General (HHS OIG) List of Excluded Individuals and Entities (LEIE) is supposed to include a roll up of vendors and individuals with state level Medicaid sanctions as well as those marked by Federal sanctions.   But a recent Associated Press article uncovers major gaps in reporting.  

Investigators surveyed the states to find out how often their Medicaid programs sanction a provider in a way that would in the vast majority of cases merit a spot in the IG’s exclusion database. An astounding 61 percent of the 4,319 sanctions imposed by state Medicaid agencies in 2004 and 2005 could not be found in the federal database.

Hospitals, long-term care providers, any one dealing with Medicare/Medicaid reimbursement will want to verify that their current vendor credentialing processes check all states — from the state lists — as well as the OIG LEIE.