Continuous Monitoring with FACIS Means Access to a Comprehensive Data Source with Real-Time Results

Continuous Monitoring of Exclusions, Sanctions, Debarments and Disciplinary Actions with FACIS Means Access to a Comprehensive Verified Data Source with Real-Time Results

Continuous monitoring with FACIS^® (Fraud Abuse Control Information System) provides comprehensive exclusion, sanction, debarment and disciplinary action data on all taxonomies, across all U.S. jurisdictions, with the click of a button. Today’s Federal and State health care program compliance laws say that a provider or entity excluded from participating in a government-funded program in one state or at the federal level in one mode of health care, is excluded from participation in every state and all manner of health care.

Compliance is designed to prevent fraud from being committed against a government-funded program, as well as to protect patients who are recipients of entitlement programs like Medicare and Medicaid. Continuous monitoring for exclusions, sanctions, debarments, and disciplinary actions is a best practice that protects an organization from Civil Monetary Penalties, fines, lawsuits, entity exclusion, and identifies non-compliant providers.

Mitigating fraud and protecting patients requires an ongoing look at the most current data on every provider, individual, and entity engaged with an institution to ensure full transparency. A provider could be stellar when hired, credentialed, and privileged, then fall into an addiction problem, be lured into a fraud scheme, or repeatedly cause harm to patients through negligence or abuse. This is an unnecessary risk given the availability of automated monitoring using FACIS powered by thousands of primary source publishers.

Continuous Monitoring with FACIS Enhances an Organization’s Ability to Qualify for Accreditation and Certifications

In addition to regulatory compliance, independent standard-setting organizations, such as the Joint Commission, offer accreditation and certifications to health care institutions that align with industry quality standards and best practices. Organizations applying for this accreditation can more easily qualify when using FACIS monitoring.

The Joint Commission, founded in 1951, is a nonprofit, standard-setting organization with over 21,000 health care institutions holding its accreditation. Its mission is: “To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.” Achieving this accreditation is a symbol of quality in hospitals and health care organizations.

After initial screening for employment or engagement, there is an ongoing need to assure the safe practices of health care providers and entities. For this purpose, The Joint Commission introduced a two-part ongoing performance measurement program in 2007.

• • Ongoing Professional Practice Evaluation (OPPE) is designed to help identify those providers who may be delivering sub-par care.
  • Focused Professional Practice Evaluation (FPPE) is the follow up process to dig deeper into those identified initially through the OPPE process.

Health care institutions design a process for OPPE and FPPE that is objective and based on criteria relevant to quality of care with input from peers and medical staff management. Adding FACIS data, as part of the ongoing monitoring, lays the foundation of objectivity and actionability.

Verisys’ data derived from a full array of primary sources including U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), SAM, FDA, DEA, FBI, U.S. Treasury Department, the U.S. Attorney General, State AGs, HEAT, Task Force news, and, State Licensing Board records provide the insights to keep patients safe and an organization safe from regulatory and legal risk. Checking a provider’s credentials upon hiring is essential, but continuous and ongoing monitoring of an individual or entity is just as crucial to mitigate fraud and risk. Verisys ensures your organization and its providers remain compliant.

Learn more about how Verisys can assist your HCOs in meeting all government and regulatory standards.

Written by Verisys Verisys transforms provider data, workforce data, and relationship management. Healthcare, life science, and background screening organizations rely on our comprehensive solutions to discover their true potential. Visit verisys.com to learn how we turn problems into power. Secure, configurable, and proven solutions Accurate, compliant, and complete information NCQA, URAC, and ISO accreditations/certifications Follow us on LinkedIn