Why conduct exclusion monitoring?

Here are a few reasons to conduct exclusion monitoring.

  1. Healthcare organizations cannot employ an excluded individual or entity if participating in any Federal healthcare program, to do so will result in fines.
  2. Several State Medicaid Agencies have their own state exclusion list.
  3. Several State Medicaid Regulations require monthly exclusion monitoring.
  4. Per the Patient Protection and Affordable Care Act (PPACA) required Center for Medicare and Medicaid Services (CMS) says you should conduct exclusion monitoring. Reference the specific guidance here. Section 6501

 

 

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