Especially for organizations in the healthcare industry and public sector, it’s important to understand how to use SAM and medical sanctions searches effectively to avoid compliance pitfalls, meet federal requirements, and maintain operational integrity to reduce the likelihood of costly penalties.
The government sanctions listed in the System for Award Management (SAM) and medical sanctions are distinct but interrelated; and, in the latter case, the difference between choosing a search that meets minimum requirements versus a comprehensive one can have a major impact on informed hiring and the ongoing protection of your workforce. Here we’ll explore the distinctions and overlap between government and medical sanctions to help you mitigate risk, avoid negligent hiring penalties, and retain access to federal funding.
What is the System of Award Management (SAM)?
The System for Award Management (SAM) can help your organization identify individuals who are excluded from federal procurement and non-procurement programs. Individuals found on this list cannot receive federal contracts, subcontracts, some forms of federal financial assistance, and certain federal benefits. The System for Award Management (SAM) service not only facilitates searches for government-excluded individuals and entities, but also helps employers register or renew information regarding federal contracts; gather information about grants and grant applications; and explore procurement and acquisition information.
Importantly, SAM also provides a list of approved contractors and entities: those who are eligible to contract with the federal government or work on federal contracts held by another company. This facet of the SAM database helps employers sustain federal contract compliance. Contractors can land on the exclusions list for a variety of reasons, ranging from acts of fraud and embezzlement to undisclosed criminal convictions, severe tax delinquency, or failure to comply with the Drug-Free Workplace Act, among other offenses.
Consequences of SAM Noncompliance
Ensuring SAM compliance by utilizing the SAM database helps federal contractors, federal subcontractors and healthcare organizations secure lasting compliance for their employees, patients, and the general public.
There are significant financial, legal, and reputational consequences to hiring an excluded individual, including the withdrawal of opportunities for future federal contracts through Medicare, Medicaid, and other programs. For instance, if a healthcare employer hires or continues to employ an excluded individual, the employer may be required to pay $10,000 for each service provided by the excluded individual/vendor. Additionally, the organization may be denied payments for any rendered services that violated exclusion laws. The organization may also be forced to repay or compensate for amounts billed by the excluded party for their/the organization’s services. Healthcare employers and employers in other industries should also stay cognizant of any local or state laws that impact employment background checks and the use of exclusions/sanctions lists.
What is the Medical Exclusion Search?
The Medical Exclusion Search primarily includes records drawn from the System for Award Management (SAM), which we’ve already discussed, as well as records from the Office of Inspector General (OIG). Of course, many additional sanction lists are accessed during a Medical Exclusion Search to ensure a more comprehensive monitoring process, including sanction lists from the Drug Enforcement Administration (DEA), the Food and Drug Administration (FDA), the TriCare Sanction list, and a number of other relevant federal agency lists. This could also include state-level Medicaid or Medicare exclusion lists, or state medical boards sanctions. Later, we’ll discuss the distinctions between a Level 1 and a Level 3 Medical Exclusion search, including the scope of data that is available/accessed with each, and the pros and cons of either approach.
In general, healthcare sanctions or medical exclusions searches are initiated by organizations that want to ensure a candidate (a medical professional) is in good legal and professional standing prior to or during employment. It’s a crucial step towards minimizing the risk of non-compliance, workplace incidents, patient harm, or the loss of federal funding due to insufficient monitoring. When a medical exclusion search reveals concerning information that disqualifies a candidate, it punctuates how essential exclusions and sanctions searches are for healthcare organizations and why identifying and stopping (early on) an individual or entity that could cause significant and compounding harm is so critical.
Level 1 vs. Level 3 Searches
A Medical Exclusion Search can reveal if a candidate is listed on one or multiple sanction lists for abuse, patient neglect, or another serious offense, penalty, suspension, or disciplinary action. Here, we’ll explore the differences in scope between a Level 1 FACIS search versus a Level 3 FACIS search. Both search types draw from thousands of government sources, but one approach is considered preferable for most organizations – to ensure thoroughness that exceeds minimum federal requirements.
A FACIS Level 1 / 1M Search meets minimal federal requirements of the Office of Inspector General (OIG) Compliance Program Guidance. In addition to utilizing the List of Excluded Individuals and Entities (LEIE), a Level 1 search includes results from the General Service Administration’s Excluded Parties List System (EPLS), a state Medicaid search, and state Medicare data when available.
A FACIS Level 3 Search is a more comprehensive option for healthcare debarment and exclusion searches, involving everything offered in a Level 1/1M Search plus a thorough search of sanctioning boards (regardless of provider type) in all 56 US jurisdictions, amounting to a search of over 3,000 official sources. Uniquely, a Level 3 Search also includes disciplinary action (board action) listings for all 50 states, drawing from over 900 regulatory and certification agencies. Level 3 reports can articulate the reason for an imposed sanction, whether it is still active, and the sanction’s end date. It also includes information about the agency or authority that took disciplinary action and the database where the individual’s name appears, whenever available.
Benefits of Conducting SAM and Medical Sanctions Searches
Adopting a comprehensive approach to conducting SAM database and medical sanctions searches can help your organization achieve all of the following outcomes:
Prioritize Patient Care and Long-Term Compliance with The Orsus Group
It’s essential to demonstrate your investment in the well-being of your workforce and patients, and to ensure your organization’s alignment with all state and federal standards. Contact the Orsus Group today to integrate comprehensive sanction screening and compliance checks into your operational protocols, safeguarding against potential legal and financial repercussions.