Healthcare Sanctions and Compliance

Healthcare sanctions & compliance screening is a specialized background check process focused on ensuring that healthcare professionals (or any individuals/entities working in healthcare settings) are not currently barred or sanctioned from participating in federal or state healthcare programs. It also involves checking for any disciplinary actions or board sanctions against those licenses. ScoutLogic’s healthcare compliance package encompasses all these checks.

The healthcare industry is heavily regulated to protect patients and public funds, which makes background checks operationally vital.

Meet legal requirements for funding and participation. If your organization bills Medicare, Medicaid or other federal healthcare programs, you are legally prohibited from employing or contracting with individuals or entities who are on the OIG exclusion list. Violating this (even inadvertently) can result in hefty civil monetary penalties and jeopardize your funding.

Protect patient safety and ethical standards. Individuals on sanction lists or with license board actions often have a history of serious professional misconduct. By screening licenses for any disciplinary actions or revocations and checking sanction lists, you ensure that you’re not hiring someone with a known history of endangering patients or unethical behavior. This is crucial for maintaining a safe environment and upholding the trust that patients place in your organization.

Protect your reputation & accreditation. Hiring or harboring a sanctioned individual can severely damage a hospital or clinic’s reputation and could impact accreditation status. Conversely, demonstrating a robust compliance screening program can be a positive factor in audits and accreditation reviews by showing your commitment to high standards and compliance.

Maintain financial integrity. Because many sanctions relate to financial fraud, such as overbilling or false claims, employing people with a track record of such behavior can cost your organization enormously or even lead to the loss of your license to operate. Screening for exclusions and sanctions is part of a strong compliance program that keeps financial dealings honest and prevents fraud internally.

Comply with law and policy. Many states require healthcare employers to check backgrounds including any sanction lists as a condition of licensure or just as best practice. Regular checks ensure you maintain continuous compliance, not just one-time at hire.

ScoutLogic provides an advanced and comprehensive approach to healthcare compliance screening that gives you confidence in every hire.

Comprehensive database coverage. We cover all major federal and state exclusion lists. This includes the OIG LEIE (List of Excluded Individuals/Entities), the GSA/SAM exclusion database, FDA debarment list, DEA registrant actions if relevant, and we also check state-specific Medicaid exclusion lists. If your organization is a federal contractor, we can cross-check OFAC sanctions, though that’s usually beyond healthcare scope. If there’s a list out there that could flag a problematic individual in healthcare, we search it.

License verification and monitoring. ScoutLogic will retrieve any publicly available information on sanctions or disciplinary actions tied to that license. We integrate license checks into the onboarding and periodic review process so that you always have up-to-date compliance data, and we even track license expiration dates for you if desired, so renewals don’t lapse.

Integrated sanctions screening with background checks. Often, sanction checks are handled separately or as an afterthought. ScoutLogic incorporates them into the overall background check workflow. You get one consolidated report that includes criminal history, employment/education verifications, and a clearly labeled section for healthcare sanctions. This integration means no step is missed, plus it saves time and reduces complexity.

Fast and ongoing compliance support. Our sanction checks are very fast – often instantaneous or completed same-day, since it’s database-driven. License verifications can also be quick via online systems, though if we have to confirm something with a board, we expedite it. Additionally, we don’t stop at the hire: we offer packages where we re-run sanction checks at regular intervals on all employees and notify you if anyone pops up as excluded.

Expert interpretation and guidance. Sanctions and healthcare compliance can be confusing. ScoutLogic doesn’t just feed you raw data; we provide context. Our Scouts can explain what an exclusion means.. And if you face a regulatory audit, we can assist in pulling records of all the checks we’ve done.