Verification
To streamline the process of verifying our vendor information and monitoring federal and state databases to screen for exclusions, we have launched VendorProof, a ProviderTrust solution.
We require each vendor to enroll in VendorProof and submit key business information regardless of the service provided (e.g., cleaning service, vehicle maintenance, decorating service, any healthcare service, etc.).
Enrollment process
All vendors are required to enter and update pertinent information through the VendorProof portal. Enrollment information includes:
- Business and contact information
- Federal tax ID#
- Ownership information
- Five-question risk survey
- Medicare Advantage attestation (if applicable)
- Current W-9
ProviderTrust will perform regular checks for OIG Exclusions, Medicare Fraud, IRS issues, and other risk-related issues, including Medicare Advantage Compliance Program requirements.
OIG exclusions
An OIG exclusion refers to an individual or business that has been flagged as a risk to federal healthcare programs and their beneficiaries.
OIG Exclusions require healthcare organizations to monitor employees along with the vendors who provide goods and services to the organization. According to the OIG, an excluded individual or entity may not provide services that are payable by federal healthcare program dollars.
Exclusions can occur for a variety of reasons, including Medicare fraud. To learn more about OIG exclusions, read this article.
Exclusion Authorities
OIG (Office of Inspector General) has the authority to exclude individuals and entities from federally funded healthcare programs pursuant to section 1128 of the Social Security Act, and from Medicare and state health care programs under section 1156 of the SSA.
OIG maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (LEIE). Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties (CMP).