Policies

Exclusion Screening

Individuals and Organizations can be excluded from participating in the Medicare and Medicaid programs for various reasons, including fraudulent billing, abuse of patients, controlled substance convictions and other prohibited activities. Healthcare providers are prohibited from employing or contracting with excluded persons or entities. If someone if excluded, that means that cannot receive federal or state payments for any items or services they furnish, order or prescribe.  

USFH has developed a Federal Health Care Program Exclusions Review policy to ensure appropriate screening and monitoring of our providers and contractors.  Screening includes but is not limited to:

  • Health and Human Services Office of Inspector General List of Excluded Individuals/Entities (LEIE)
  • US Treasury Office of Foreign Asset Control (OFAC) consolidated sanctions 
  • US Treasury OFAC Specially Designated Nationals
  • System for Award Management (SAM
  • State Medicaid sanctions