HR ProFile May 2016 Webinar OIG-OFAC-GSA … SAM Exclusions Exclusions Terrorists Exclusions ... General Services Administration - GSA 14 Harry Truman established GSA in 1949 , to

5/20/2016

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©Copyright 2016 HR ProFile, Inc. All Rights Reserved

OIG – OFAC - Terrorist Watch List

What is in a criminal background check?

Presented By::

NICKOLAS SAKELOS

HUMAN RESOURCE PROFILE, INC.CINCINNATI, OH

MAY 20, 2016

Sonja McLaughlin

Client [email protected]

800-969-4300

Presenter:

Nickolas SakelosDirector of Information Systems

[email protected]

Harry Settle

Enterprise Accounts [email protected]

800-969-4300


� Welcome!

� Introductions

� Purpose of Presentation

� Content Presentation

� Q & A’s throughout and at end

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Nickolas Sakelos

Director of Information Systems, HR ProFile

• With HR ProFile since 1999

• General Manager Operations, Production, Information Systems

• Deep subject matter expertise relative to Compliance

Prior to HR ProFile

• Manager of Information Systems for a private financial advisory firm serving Public, Private, and Government contracts

• Mr. Sakelos earned his Bachelor of Science from Vanderbilt University

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Objective:

Today we are going to discuss OIG – GSA - OFAC – Global Watch Lists and others.

You will learn:

1. Main differences between applicable Government Agencies

2. How the searches are conducted

3. Understand how these relate to your screening process

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� Blacklists

� Exclusions

� Sanctions

� Primary Source

� Proprietary Databases

�CRA – Consumer Reporting Agency

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OFACFingerprin

ting

Global W

atch List

FBI

FBI

Fingerprinting

FACIS Level 1

FACIS Level 1

FACIS Level 1M

FACIS Level 1M

FACIS Level 2

FACIS Level 3

OFA

C

OFA

C

OIG

OIG

GSA

GSA

SDN’s SDN’s

Global Watch List

Patriot Watch List

FACIS Level 2

Patriot Watch List

Interpol

Interpol

OFSIOFSI

HHS

HHS

LEIE

LEIE

SAM

SAM

Exclusions Exclusions

ExclusionsTerrorists

Terro

rists

Terrorists

HSPD-6

HSPD-6

CMS

CMS

OBRA

OBRA

NCIC

NCIC

EPLS

EPLS

OIG

GSA

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SDN Specially Designated Nationals

~ Terrorist Watch List ~

Global Watch List

Patriot Search

Sanction Watch

The Patriot Act

SAM – EPLSExcluded Parties List System

LEIEList of Excluded Individuals

and Entities

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OFAC

Office of Foreign Assets Control

OIG

Office of Inspector General

GSA

General Services Administration

ProprietaryDatabase Searches

US Treasury

Private Companies

US GovernmentIndependent Agency

HHSHealth and Human

Services




Global Watch List

Patriot Search

Sanction Watch

The Patriot Act



and Entities

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OFAC


OIG


GSA


Proprietary Database Searches

US Treasury

Private Companies


HHSHealth and Human

Services


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� OIGwhich was established in 1976 and works to eliminate fraud, abuse, and

waste in Medicare, Medicaid and over 300 other US Department of Health and Human Services (HHS) programs.

� OIG has legislative authority to exclude individuals and entities from

Federally funded health care programs.

� Monthly Database of current individual and entity exclusions called the List

of Excluded Individuals and Entities - LEIE. It does NOT automatically

incorporate State & Federal Levels, must search each one depending on

your program.

� OIG negotiates Corporate Integrity Agreements (CIAs) and Integrity Agreements (IAs) with providers of Federal health care programs regarding their civil settlement obligations.

� OIG can demand monetary/stipulated penalties for failure to comply with

CIA/IA obligations.

� Anyone who hires an individual or entity on the LEIE may be subject to Civil Monetary Penalties (CMP) and in order to avoid CMP Liability, health care

entities need to check the LEIE regularly regarding both new-hires and

existing employees.

� How to conduct OIG searches: Directly to Federal Agency site (http://oig.hhs.gov) OR via Proprietary Database Searches.

OIG

HHS

LEIE

CIA’s IA’s

CMP

Office of Inspector General - OIG


10Office of Inspector General - OIG


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From June 18th, 2015 Department of Justice Press Release: Health and Human Services (HHS)

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

OIG Reportable Events, 2015 - Foote Memorial Hospital d/b/a Allegiance Health (Allegiance),Michigan, agreed to pay $2,635,441.35 for allegedly violating the Civil Monetary Penalties Law.OIG alleged that Allegiance submitted claims to Federal health care programs for hyperbaricoxygen therapy services that did not meet Provider-Based Regulations

From February 2016 HHS Report – The Texas Department of Aging and Disability

Services had incorrectly claimed some costs that were not for medical services

as Medicaid medical assistance expenditures. Agency to refund $567,892

to the Federal Government.

Over 63,000 individuals and entities currently on the LEIE Exclusions list

(234 going into effect 3-20-16)

OIG – Violations


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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.

The Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act.

OIG – Violations

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Global Watch List

Patriot Search

Sanction Watch

The Patriot Act



and Entities

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OFAC


OIG


GSA



US Treasury

Private Companies


HHSHealth and Human

Services


14General Services Administration - GSA

� Harry Truman established GSA in 1949, to consolidate departments and help

the Federal government streamline – involving Administrations, Archives, Buildings, Supply, Contracts, War Assets, Records, Surplus, Emergency

Preparedness.

� GSA is involved with government contracting, procurement, construction,

and maintenance of federal buildings.

� The Suspension & Debarment Division (S&D) processes suspension and debarment cases.

� The System for Award Management (SAM) is the Official U.S. Government system currently consolidating the Central Contractor Registry (CCR) - Federal

Agency Registration (Fedreg) - Online Representations and Certifications

Application (ORCA) - and the Excluded Parties List System (EPLS).

� GSA administers Excluded Parties List System (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

(https://www.sam.gov) OR Proprietary Database Searches

GSA

EPLS

SAM

S&D


15General Services Administration - GSA


16GSA – Violations

Over 115,000 individuals on list


17GSA – Violations


Global Watch List

Patriot Search

Sanction Watch

The Patriot Act


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GSA



Private Companies



and Entities

OIG


HHSHealth and Human

Services



OFAC


US Treasury

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19Office of Foreign Assets Control - OFAC

� OFAC - Successor to the Office of Foreign Funds Control, was established in 1940 - World War II following the German invasion of Norway.

� Under The US Treasury Department - Financial Sanctions, Office of Terrorism and Financial Intelligence.

� OFAC 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.

� OFAC compiles from 29 separate sanctions lists and publishes as list of individuals and companies called the Specially Designated Nationals and Blocked Persons List -SDN List. Although not the official name, the SDN list is often referred to as The Terrorist Watch List.

� How to Conduct this search: Directly to Federal Data Source US Treasury site (https://sanctionssearch.ofac.treas.gov). Slow and cumbersome process OR utilize the Private Proprietary Consolidated search providers.

� Other countries have similar lists – ex: Canada, Mexico, EEU.

OFAC

29 Separate Sanctions Lists

SDN

~Terrorist Watch List~

US Treasury


20Office of Foreign Assets Control - OFAC


21OFAC Sanctions – SDN’s

OFAC SDN’s List - Compiled from 29 Separate Sanctions Lists

OFAC SDN’s List – Currently 948 PDF PAGES


22OFAC Violations





and Entities

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OFAC


OIG


US Treasury

HHSHealth and Human

Services

Global Watch List

Patriot Search

Sanction Watch

The Patriot Act


Private Companies


GSA





The Single Search Proprietary Database 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:

Patriot Search

The Patriot Act

Sanction Watch List

Global Watch List

Electronic Data

Availability

Proprietary Databases

Bureau of Industry and Security (BIS) Denied EntitiesFBI’s Ten Most Wanted FugitivesInterpol Most Wanted World Bank Debarred PartiesUS Postal Service Most WantedUS Marshals Most WantedICE – Most Wanted Criminal Aliens

Sanctions and Exclusions lists included in such proprietary group searches can include data from up to 50+ sources such as:

In addition to these Government agencies OIG – GSA – OFAC the increasing availability of electronic data has seen a Fourth

resource emerge in past 7-8 years.

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PRIMARY SOURCE PROPRIETARY DATABASE

INDUSTRY

Specific


26Industry Specific Lists

PRIMARY SOURCE PROPRIETARY DATABASE


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NPDB

PRODUCT

HEALTH CARE

PRIMARY SOURCE

� National Practitioner Data Bank (NPDB) an information repository created by Congress under Health & Human Services 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 2013.

� 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.

Example – A Primary Source Industry Specific Database


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FACIS

PRODUCT

HEALTH CARE

PRIVATE

� PrivateCompany Database relating to Healthcare Industry.

� One private company, formerly known as GMS – Government Management Services - was founded in 1992 by former Department of Health and Human Services 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 OIG, GSA, 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.

� OFAC Plus – Added optionally at no additional cost.

Example – A Proprietary & Industry Specific Database


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� Verify your CRA’s (Consumer Reporting Agency)

Subject Matter Expertise

� Intricacies of Name Variations – Each

provider/source

� Pre-Hires – Adverse Action/Rescind offer?

� Pre-Billing services - Vendors – Ownership

� Current Staff/Vendors - Monthly or Yearly

� Remediation, Self Disclosure, or Termination?




Global Watch List

Patriot Search

Sanction Watch

The Patriot Act



and Entities

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OFAC


OIG


GSA



US Treasury

Private Companies


HHSHealth and Human

Services

Federal

State

INDUSTRY SPECIFIC

5/20/2016

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� Q&A’s

� Your Background Screening company is your guide, please be sureto discuss these matters with them and feel free to reach out to usat HR ProFile any time as well, we want to be sure YOU are

compliant

� Certificates HRCI - SHRM

� Thanks for attending!

HR ProFile http://hrprofile.com

OIG http://oig.hhs.gov

http://oig.hhs.gov/exclusions/background.asp

GSA http://www.gsa.gov/portal/category/106579

EPLS/SAM https://www.sam.gov

OFAC https://sanctionssearch.ofac.treas.gov

©Copyright 2016 HR ProFile, Inc. All Rights Reserved©Copyright 2015 HR ProFile, Inc. All Rights Reserved

HR ProFile, Inc. is a full-service, trusted, industry leader with25 years of experience in all areas of Human Capital

Management and Employee Background ScreeningIncluding:

CriminalReference

Employment History Scholastic/Certification Verification

Moving Violation ReportsDrug TestingClinical ExamsCredentialing

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 asunparalleledpersonal and professional customer service.

Visit us at http://www.hrprofile.com/

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Documents

HR ProFile May 2016 Webinar OIG-OFAC-GSA … SAM Exclusions Exclusions Terrorists Exclusions ... General Services Administration - GSA 14 Harry Truman established GSA in 1949 , to