How often should a home health agency screen the OIG exclusion list?

Short answer: monthly, for every current employee and contractor, with proof kept of each search. That is OIG's own recommendation, and it is the standard a Medicare or Medicaid auditor will measure you against.

What OIG actually says

The Office of Inspector General's Special Advisory Bulletin on the Effect of Exclusion (May 2013) is the controlling guidance. It notes there is no statute that requires checking the List of Excluded Individuals and Entities (LEIE), then states that screening employees and contractors each month best minimizes potential overpayment and civil monetary penalty liability. OIG updates the LEIE monthly and recommends it as the primary source for screening.

In plain terms: a person can be excluded any month. A check at hire covers the day they started and nothing after.

Who has to be screened

Everyone whose work is paid for, directly or indirectly, by a federal health care program: nurses, therapists, aides, office staff whose salary is part of the cost report, and contractors, including workers supplied by a staffing agency. The bulletin is explicit that liability extends to contracts with excluded entities such as staffing agencies, and that outsourcing the screening to a vendor does not move the liability off the provider.

What it costs to get it wrong

Employing or contracting with an excluded person exposes the agency to civil monetary penalties for each item or service the excluded person furnished, plus an assessment of up to three times the amount claimed. The per-item penalty is adjusted for inflation every year and sits in the tens of thousands of dollars; the current figure is published in 45 CFR part 102. For an aide making daily visits, "each item or service" adds up fast. OIG offers a Self-Disclosure Protocol for providers who find a problem themselves; the terms are better than waiting to be found.

What proof to keep

The bulletin recommends keeping documentation of the initial search and every later one, for example a screenshot, so you can show an auditor that the check happened and what it returned. The useful record for each person and each month is: the date, the list version checked, the result, and, for a possible match, who reviewed it and how it was resolved.

Handling possible matches

Common names return false positives. The LEIE carries date of birth and other identifiers for most records; a possible match is resolved by comparing those to the employee's record, and OIG's online tool lets you verify a match by Social Security number. Write down the comparison. A cleared match that reappears next month should not need to be re-investigated if the clearing decision was recorded.

State lists

Many state Medicaid programs keep their own exclusion lists and require providers to check them as well. California's Medi-Cal Suspended and Ineligible Provider List is one example. If you bill Medicaid, add the state list to the monthly pass.

Doing this without a spreadsheet and a calendar reminder

Monthly screening for thirty or three hundred people is a mechanical job: download the new list, run every active name, review the possibles, file the proof. Benson HR runs that job automatically each time OIG publishes a new list, clears records that plainly belong to a different person, holds real possibles for your review, and files the proof of each check in the person's record. The screening page describes it.