by Roger Shindell, MS, CHPS, CISA, CIPM
In today's highly competitive job market, employers are becoming increasingly vigilant in their efforts to ensure the safety, integrity, and compliance of their workforce. Two essential tools in this endeavour are pre- employment background checks and Office of Inspector General (OIG) exclusion screening. While both serve the purpose of mitigating risks associated with hiring new employees, they differ significantly in terms of scope, purpose, and regulatory requirements. In this article, we will explore the key distinctions between pre- employment background checks and OIG exclusion screening.
Pre-employment background checks have long been a standard practice in the hiring process for many organizations. These checks involve a comprehensive review of an applicant's history, aiming to uncover any red flags that may be indicative of potential issues in the workplace. The primary objectives of pre-employment background checks include:
Criminal History: Background checks typically include a search for any criminal convictions, pending charges, or records of arrests. This helps employers assess whether an applicant may pose a risk to their workplace or clients.
Employment History: Employers verify an applicant's employment history to confirm their qualifications, experience, and consistency in work-related information provided in their resume or application.
Education Verification: Employers may verify an applicant's educational credentials to ensure they possess the necessary qualifications for the job.
Reference Checks: Contacting an applicant's professional references can provide valuable insights into their character and work ethic.
Credit History (in some cases): In certain roles, especially those involving financial responsibility, employers may review an applicant's credit history to assess their financial stability.
Social Media Screening (optional): Some employers conduct checks on an applicant's online presence to gain insights into their character and behavior outside of the workplace.
Pre-employment background checks are subject to federal and state laws, including the Fair Credit Reporting Act (FCRA) and Title VII of the Civil Rights Act of 1964, which require employers to adhere to certain guidelines to ensure fairness and prevent discrimination during the hiring process.
OIG exclusion screening, on the other hand, is a specific regulatory requirement imposed on certain types of healthcare organizations and their employees. The OIG, a federal agency, administers exclusion screening to prevent individuals and entities that have been convicted of healthcare-related crimes or fraud from participating in federal healthcare programs. The main purposes of OIG exclusion screening are:
Protecting Federal Healthcare Programs: Exclusion screening helps safeguard federal healthcare programs like Medicare and Medicaid by ensuring that unscrupulous individuals or entities cannot participate in these programs.
Preventing Fraud and Abuse: Screening helps prevent individuals or entities with a history of healthcare fraud or abuse from re-entering the industry.
Ensuring Compliance: Healthcare providers and organizations must conduct exclusion screening to demonstrate compliance with federal regulations.
OIG exclusion screening involves checking the OIG's List of Excluded Individuals/Entities (LEIE) to confirm that current or prospective employees and contractors are not on the exclusion list. Healthcare providers are legally required to perform this screening regularly, and failure to do so can result in severe penalties and fines.
Scope: Pre-employment background checks are broader in scope and applicable across various industries, while OIG exclusion screening is specific to healthcare organizations and their employees.
Purpose: Background checks aim to assess an applicant's overall suitability for a job, including their qualifications, character, and criminal history. In contrast, OIG exclusion screening focuses on preventing individuals with healthcare-related convictions from participating in federal healthcare programs.
Regulatory Requirement: While pre- employment background checks are often conducted voluntarily by employers, OIG exclusion screening is a mandatory regulatory requirement for healthcare providers participating in federal programs.
In summary, pre-employment background checks and OIG exclusion screening serve distinct purposes in the hiring process. Pre- employment background checks are a valuable tool for employers across various industries to assess an applicant's qualifications and character, while OIG exclusion screening is a crucial regulatory requirement for healthcare organizations to ensure compliance and protect federal healthcare programs. Employers must understand these differences and tailor their screening processes accordingly to meet their specific needs and legal obligations.
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