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Recent Publications

Managed Care

New Sanction Screening Challenges for Managed Care Organizations

By Jillian Bower Concepcion | January 2016 | Managed Care
Published in Managed Care Outlook Volume 25, Number 19

Pursuant to the U.S. Department of Health and Human Services (HHS) Office of Inspector General’s (OIG’s) “Compliance Program Guidance for Medicare + Choice Organizations Offering Coordinated Care Plans,” managed care organizations (MCOs) are mandated to screen all employees and contracts, which include physicians within their network.  The guidance states that they should “utilize Government resources to determine whether such individuals or entities are debarred or excluded.” Furthermore,”[l]ists of debarred and excluded individuals and entities are currently maintained by both the OIG and the General Services Administration.”

Editor's Note: This article was originally published in the October 1. 2012 Edition of Managed Care Outlook. Published here with permission.

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