OFAC GSA OIG 5/20/2016. Exclusions HHS HSPD-6 LEIE OFAC. OIG OFAC - Terrorist Watch List FBI. What is in a criminal background check?

Transcription

1 - Terrorist Watch List What is in a criminal background check? Presented By:: NICKOLAS SAKELOS HUMAN RESOURCE PROFILE, INC. CINCINNATI, OH MAY 20, 2016 Welcome! Introductions Purpose of Presentation Content Presentation Q & A s throughout and at end 2 Presenter: Nickolas Sakelos Director of Information Systems nsakelos@hrprofile.com Harry Settle Enterprise Accounts Manager hsettle@hrprofile.com Sonja McLaughlin Client Advocate smclaughlin@hrprofile.com Objective: Today we are going to discuss - Global Watch Lists and others. You will learn: Nickolas Sakelos Director of Information Systems, HR ProFile With HR ProFile since 1999 Manager Operations, Production, Information Systems Deep subject matter expertise relative to Compliance 1. Main differences between applicable Agencies 2. How the searches are conducted 3. Understand how these relate to your screening process Prior to HR ProFile Manager of Information Systems for a private financial advisory firm serving Public,, and contracts Mr. Sakelos earned his Bachelor of Science from Vanderbilt University 5 6 Blacklists Exclusions Sanctions Primary Source s CRA Consumer Reporting Agency Terrorists Interpol Exclusions OBRA Patriot Watch List NCIC FACIS Level 1 Exclusions Patriot Watch List FACIS Level 2 EPLS NCIC s Interpol Terrorists HSPD-6 CMS Fingerprinting FACIS Level 1M Fingerprinting EPLS FACIS Level 2 FBI FACIS Level 3 OFSI FACIS Level 1M OBRA s FBI FACIS Level 1 OFSI CMS SAM HSPD-6 Terrorists Exclusions SAM 1

2 CIA s IA s CMP which was established in 1976 and works to eliminate fraud, abuse, and waste in Medicare, Medicaid and over 300 other Department of Health and Human () programs. has legislative authority to exclude individuals and entities from Federally funded health care programs. Monthly of current individual and entity exclusions called the List of Excluded Individuals -. It does NOT automatically incorporate State & Federal Levels, must search each one depending on your program. negotiates Corporate Integrity Agreements (CIAs) and Integrity Agreements (IAs) with providers of Federal health care programs regarding their civil settlement obligations. can demand monetary/stipulated penalties for failure to comply with CIA/IA obligations. Anyone who hires an individual or entity on the may be subject to Civil Monetary Penalties (CMP) and in order to avoid CMP Liability, health care entities need to check the regularly regarding both new-hires and existing employees. How to conduct searches: Directly to Federal Agency site ( OR via. Violations From June 18 th, 2015 Department of Justice Press Release: () announced nationwide sweep led by the Medicare Fraud Strike Force in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings 11 Over 63,000 individuals and entities currently on the Exclusions list (234 going into effect ) Violations Medicare Fraud Strike Force (est 2007) with operations in nine locations have charged over 2,300 defendants who collectively have falsely billed the Medicare program for over $7 billion. 12 From February 2016 Report The Texas Department of Aging and Disability had incorrectly claimed some costs that were not for medical services as Medicaid medical assistance expenditures. Agency to refund $567,892 to the Federal. The Centers for Medicare & Medicaid (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act. Reportable Events, Foote Memorial Hospital d/b/a Allegiance Health (Allegiance), Michigan, agreed to pay $2,635, for allegedly violating the Civil Monetary Penalties Law. alleged that Allegiance submitted claims to Federal health care programs for hyperbaric oxygen therapy services that did not meet Provider-Based Regulations 2

3 13-14 Harry Truman established in 1949, to consolidate departments and help the Federal government streamline involving s, Archives, Buildings, Supply, Contracts, War Assets, Records, Surplus, Emergency Preparedness. S&D is involved with government contracting, procurement, construction, and maintenance of federal buildings. The Suspension & Debarment Division (S&D) processes suspension and debarment cases. SAM EPLS The System for Award Management (SAM) is the Official U.S. system currently consolidating the Central Contractor Registry (CCR) - Federal Agency Registration (Fedreg) - Online Representations and Certifications Application (ORCA) - and the (EPLS). administers (EPLS) available through the SAM system, with Federal agency debarment actions, active exclusions list updated daily. It lists contractors excluded from doing Federal business including contracts, subcontracts, Federal financial and non-financial assistance. How to conduct searches: Directly to Federal Agency site ( OR - 15 Violations 16 Over 115,000 individuals on list Violations

4 Separate Sanctions Lists ~Terrorist Watch List~ - Successor to the Funds Control, was established in World War II following the German invasion of Norway. Under The Department - Financial Sanctions, Office of Terrorism and Financial Intelligence. deals with foreign policy, national security, trade and economic sanctions involving trafficking, regimes, terrorists, weapons of mass destruction, threats to United States policy, economy, national security. compiles from 29 separate sanctions lists and publishes as list of individuals and companies called the and Blocked Persons List - List. Although not the official name, the list is often referred to as The Terrorist Watch List. How to Conduct this search: Directly to Federal Data Source site ( Slow and cumbersome process OR utilize the Consolidated search providers. Other countries have similar lists ex: Canada, Mexico, EEU. Sanctions s s List Currently 948 PDF PAGES 21 Violations 22 s List - Compiled from 29 Separate Sanctions Lists Electronic Data Availability s In addition to these agencies the increasing availability of electronic data has seen a Fourth resource emerge in past 7-8 years. The Single Search option. Providers of Groupings of Sanctions, Exclusions and other database Lists. Efficient, cost effective and often utilized by Background Screening companies for purposes of Employment Screening. These are often referred to as the: Sanctions and Exclusions lists included in such proprietary group searches can include data from up to 50+ sources such as: Global Watch List Patriot Search Bureau of Industry and Security (BIS) Denied Entities FBI s Ten Most Wanted Fugitives Interpol Most Wanted World Bank Debarred Parties Postal Service Most Wanted Marshals Most Wanted ICE Most Wanted Criminal Aliens Sanction Watch List The Patriot Act 4

5 25 Industry Specific Lists 26 INDTRY Specific PRIMARY SOURCE PROPRIETARY DATABASE PRIMARY SOURCE PROPRIETARY DATABASE Example A Primary Source Industry Specific 27 Example A & Industry Specific 28 PRIMARY SOURCE HEALTH CARE PRODUCT NPDB National Practitioner Data Bank (NPDB) an information repository created by Congress under Health & Human via the Health Care Quality Improvement Act of 1986 (HCQIA). To improve health care quality, protect the public, and reduce health care fraud and abuse in the U.S., by providing information on medical malpractice and adverse actions on care practitioners, entities, providers, and suppliers. Further intent is to prevent incompetent practitioners from moving state-to-state without disclosure or discovery of previous issues. The Reports are confidential not available to the public. The HIPAA of 1996 created a Healthcare Integrity and Protection Data Bank (HIPDB), to combat fraud and abuse in health insurance and health care delivery. The HIPDB was officially merged into the NPDB in To use it, a Company must obtain an account, as well as their background check company to be an agent of the system. A person search is via Name, Address, SSN, License (Type, #, and State, if applicable). An Entity search is via Name, Address, FEIN. PRIVATE HEALTH CARE PRODUCT FACIS Company relating to Healthcare Industry. One private company, formerly known as GMS Management - was founded in 1992 by former Department of Inspector and others. One of their PRODUCTS is a FACIS Search. FACIS stands for Fraud and Abuse Control Information System. FACIS Level 1 Baseline search of sanction information from,, FDA, and other Federal agencies. FACIS Level 1M - Includes all level 1 Federal data plus all State level FHEP (Federal Health Entitlement Programs) data, and is considered best practice per Compliance Program Guidance. FACIS Level 2 - Combines the Level 1 search of the Federal agencies with disciplinary action information from multiple agencies and ONE state of choice. FACIS Level 3 - Most robust search option, allowing you to conduct a search of disciplinary actions taken by federal agencies as well as those taken by licensing and certification agencies in all 50 states. This is the most comprehensive search method available. Plus Added optionally at no additional cost Verify your CRA s (Consumer Reporting Agency) Subject Matter Expertise Intricacies of Name Variations Each provider/source Federal State Pre-Hires Adverse Action/Rescind offer? Pre-Billing services - Vendors Ownership Current Staff/Vendors - Monthly or Yearly Remediation, Self Disclosure, or Termination? INDTRY SPECIFIC 5

6 31 28 Q&A s Your Background Screening company is your guide, please be sure to discuss these matters with them and feel free to reach out to us at HR ProFile any time as well, we want to be sure YOU are compliant Certificates HRCI - SHRM Thanks for attending! HR ProFile EPLS/SAM HR ProFile, Inc. is a full-service, trusted, industry leader with 25 years of experience in all areas of Human Capital Management and Employee Background Screening Including: Criminal Reference Employment History Scholastic/Certification Verification Moving Violation Reports Drug Testing Clinical Exams Credentialing Competency Assessments We partner with our clients to ensure best hiring practices and Fair Credit Reporting Act (FCRA) compliance. HR ProFile provides market leading innovation to HR professionals in all industries Nationally and Internationally, customized and scalable solutions and pricing, as well as unparalleledpersonal and professionalcustomer service. Visit us at Copyright HR ProFile, Inc. Inc. All All Rights Rights Reserved Reserved 6