What is a Healthcare Sanctions Report?

What is a Healthcare Sanctions Report?


Examine your staff as closely as they examine their patients.

Healthcare is a booming industry in the United States. Unfortunately, with any booming industry comes at least some kind of corruption. Which is why, if you’re hiring medical personnel, you need to run a healthcare sanctions report.

What Is A Healthcare Sanctions Report?

Essentially, a healthcare sanctions report is a look at the List of Excluded Individuals and Entities, or LEIE, maintained by the Office of the Inspector General. The exclusion in question is from any federal healthcare programs, including Medicare and Medicaid. Of note, the list only includes persons and entities who are currently sanctioned; if a sanction is lifted, they won’t be on the list.

Despite how it sounds, it’s actually quite difficult to receive a sanction in the first place. The Office of the Inspector General issues notices to exclude, and there’s an extensive appeals process that can go all the way to federal court. So you’re unlikely to find anybody on the sanctions list unless they have absolutely no other way to get off of it, and fail to apply to be removed from the list.

How Do You Get Sanctioned?

Sanctions are generally imposed for two actions: Fraud and abuse. While the two are often lumped together, there is a fundamental difference. Fraud is an obvious definition, but abuse is worth knowing about. Under the law, though, abuse is defined as any behavior that’s inconsistent with accepted medical practice, whether it’s viewed as procedures that were medically unnecessary, don’t meet the government’s definition of professionally recognized standards, or unfair pricing. That’s a bit more open-ended than fraud, and you should ask a few questions about that if somebody turns up on the list.

medic-563425_640Your staff should be top-notch.

How Is A Sanctions Report Run?

Generally, you can run a report using data such as a Social Security number, a Unique Physician Identification Number, or UPIN, or a National Provider Identifier, or NPI. It’s often advisable to use both when possible, as records can be incomplete, or some of those sanctioned may not have the latter two.

Why Should I Run One?

There are a few different reasons to run this important report. The most obvious, of course, is to spot incompetent or fraudulent medical personnel. No medical facility wants to put patients at risk, and a sanctions report will help you find and reject personnel unsuitable to work at your facility.

Secondly, it protects you from multiple forms of liability. The problem of malpractice lawsuits is, of course, an ever-present threat to medical facilities of all shapes and sizes. Malpractice lawsuit payouts cost medical facilities billions every year, and can shut smaller facilities down completely.

But that’s not the only legal risk. It’s not well known outside of legal circles, or those who have been sued over it, but negligent hiring is a very real legal threat for every kind of business. Failing to study who you’re hiring, and using that information to make a proper hiring decision, can find you liable for the actions of that employee. That makes a healthcare sanctions report crucial to pair with a background check for any medical facility’s hiring process.

Patients need to trust their doctors, and you need to trust your employees. If you want to ensure your patients are getting the best care, contact us about background checks and employee verification. We’ll help you ensure only the best staff are working at your facility.

Get a FREE Healthcare Sanctions Report

Click here to get your free background check