IEHP has implemented a screening process to identify individuals and entities that appear on the Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE), the General Services Administration (GSA) System for Award Management (SAM), the CMS Preclusion List, and the DHCS Medi-Cal Suspended and Ineligible Provider List prior to appointment, contracting, and/or employment and monthly thereafter to ensure that none of these individuals or entities are excluded, ineligible or terminated from participation in State and Federal health care programs.
Delegated Subcontractors must implement a screening program for employees, Board Members, contractors, and business partners to avoid relationships with individuals and/or entities that tend toward inappropriate conduct.
This program includes but is not limited to:
- Prior to contract and monthly thereafter, review of the OIG LEIE, GSA SAM, DHCS Medi-Cal Suspended and Ineligible list, to identify individuals and entities that are excluded from participation in government health care programs (42 CFR §10011901).
- A monthly review of the DHCS Medi-Cal Suspended and Ineligible Provider List.
- Criminal record checks when appropriate or as required by law.
- Review of the National Practitioner Databank (NPDB).
- Review of professional license status for sanctions and/or adverse actions.
- Reporting results to Compliance Committee, Governing Body, and IEHP as necessary.