Why NEMT Providers Need to Take OIG Exclusion Screening Seriously
Compliance in the non-emergency medical transportation industry involves much more than ensuring drivers arrive on time and trips are properly documented. NEMT providers participating in Medicaid and other federally funded healthcare programs also need to understand who they employ and whether those individuals are eligible to participate in federally funded healthcare programs.
One important part of that responsibility is screening employees and certain contractors against the U.S. Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities (LEIE).
An individual or entity appearing on the exclusion list may be prohibited from receiving payment, directly or indirectly, from federal healthcare programs for items or services they furnish, order, or prescribe.
For transportation providers, this is an area of compliance that can sometimes be overlooked.
Screening shouldn’t be a one-time event
Checking an employee when they are initially hired is an important first step, but an individual’s exclusion status can change after employment begins.
That makes exclusion screening something NEMT providers should incorporate into their ongoing compliance processes rather than treating it as another box to check during onboarding.
Providers should have documented procedures addressing who is screened, when screening occurs, how results are reviewed, and how the organization responds when a potential match is identified.
Documentation is equally important. Like many areas of healthcare compliance, being able to demonstrate that an appropriate process was actually followed can become important during an audit or investigation.
Technology can make compliance easier
NEMT providers already have a significant amount of information to manage. Driver credentials, vehicle information, trip records, broker requirements, billing documentation, and employee records can quickly become difficult to track across multiple systems.
Good transportation management software should help operators reduce that administrative burden.
Mobility Route believes compliance tools should be incorporated into the systems providers already use to operate their businesses whenever practical. Automating routine compliance processes can reduce the possibility that an important check is simply forgotten while still allowing management to review and respond to the results.
Technology cannot replace an effective compliance program, but it can make following that program considerably easier.
For NEMT providers participating in Medicaid and other healthcare programs, exclusion screening is one more reason that employee management and compliance should be treated as an important part of transportation operations—not merely an administrative afterthought.
