CMS - Centers for Medicare and Medicaid Services
MGMA - National Medical Group Management Association / American College of Medical Practice Executives (now one combined organization)
MGMA e-News Scan - The MGMA e-News Scan is a content portal that aggregates all the pertinent healthcare information of the day in one easy-to-access place. With one click you have all your healthcare news in one spot – neatly summarized – so you can stay on top of all the important information that might affect you, your job, your profession and your industry.
Noridian Medicare - Medicare Part B Carrier/Contractor for Oregon
NPI Registry - Search for NPI numbers (NPPES National Plan and Provider Enrollment Services)
OHA - The Oregon Health Authority
OIG Exclusions Check
OMA - The Oregon Medical Association
Oregon Medical Board - Physician and PA Licensing for the State of Oregon
One Health Port - Single sign on resource for accessing insurance plans and provider credentialing* (*future)
PECOS - Medicare Enrollment and Reattestation
If your specialty is not listed here, please email their name and web address to Jeff Baird at jeffb@ENTsalem.com.
OMGMA Members may qualify for discounts just for being an OMGMA Member
Check out these offers!
Discount for Worker's Compensation insurance through SAIF Corporation (if your group qualifies). Be sure to check with your insurance agent and let him/her know you are an OMGMA Member to see what discount your clinic may be eligible for.
CMS Exclusion List
Federal Exclusion - Insights from an Insider
I'm the founder of Verify Comply, and we help companies navigate the world of State and Federal exclusion and debarment. In my job I talk a lot, but I try to listen even more. I often hear the same themes from prospective clients, so I thought that sharing some of these reflections might be helpful.
Why Do I Need to Screen Everybody?
Misconceptions seem to exist around what it takes to be placed on an exclusion list. I hear this one a lot: "I've known him for years and he's never been in trouble, so how could he be excluded?" It's unfortunately not that simple. Federal healthcare exclusion comes in two flavors - Mandatory and Permissive. "Mandatory Exclusions" are fairly well known - these are typically actions that result from criminal offenses such as Medicare/Medicaid fraud and patient abuse and neglect. "Permissive Exclusions," on the other hand, can be sneaky. Did you know that exclusion can occur for defaulting on health education loans? It's true! The government doesn't pay those who don't pay them. Exclusions can pop-up at any time, even for folks you would never suspect. The point? Screen everyone, and screen them monthly - even if you know them.
Will the Government Really Find Out?
So you identified an excluded party on staff. Now what? Well, you're supposed to self-report, but human nature almost always raises the question, "How will they know?" The answer is surprisingly simple. One's first thought might be the use of tax returns, but the examples I've seen are even simpler. When an excluded party applies for reinstatement, the Feds ask for employment history! So, the answer to the question posed here is, "yes, the government really will find out." You aren't doing your staff member or yourself any favors by not reporting.
What do Mistakes Cost?
Civil Monetary Penalties are the answer - and the fed's authority to issue treble (three times) the value of the infraction. Fines are calculated differently based on the nature of services provided by the excluded party and the duration of the event. However, what you should know is the government has great liberty as to how penalties are levied, and it's been shown that prompt self-reporting can significantly reduce the fines. And, of course, don't forget that the government is not the only entity out there that might seek redress. If you are a subcontractor or lower tier contractor, using excluded individuals is probably a breach of contract. Losing your contract, on top of Civil Monetary Penalties, makes careful screening and self-reporting crucial.
How Can I Comply with Monthly Checks?
Checking the debarment/exclusion lists must be done up-front and monthly for all of your employees and contractors. Whether you have 300 or 3000 or 30,000+ that need screening, this task might seem daunting, at best. The good news here is that screening up front and on a monthly basis is pretty easy and cost efficient, especially with Verify Comply services that do much of the work for you. While the federal (and state, where applicable) databases are free to search, they aren't very efficient (think: searching each person manually on at least two different databases). One client screening just 350 people estimated this would take a single employee around 40 hours each month. Commercial services, however, allow you to search all the databases at once, often pulling data from a spreadsheet or from integration with your payroll software or service provider. That same client reports that the monthly screens only takes minutes per month using our services.
Verify Comply's Free Portal(tm) (yes, it's free!) simplifies this task by allowing companies to scan an employee or vendor name against all available Federal and State exclusion lists in one search. Portal Pro(tm) builds on this functionality by automatically screening your lists of employees & vendors monthly and emailing a summary of the name match results. Portal Pro(tm) is designed to handle large data sets with intuitive workflows, advanced list synchronization utilities, multiple role-based users, and unlimited searches.
A Portal Pro(tm) subscription retails at $39.95 monthly, but OMGMA members can use the promo code "WRS3" during checkout to receive $10 off for the first 12 months ($29.95/mo). Please visit www.verifycomply.com for more information or to request a demo! We look forward to hearing from you!
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