What populations should I monitor for exclusions?

Both provider and payer organizations that receive Medicare and/or Medicaid funding have populations that should be monitored for exclusions. The OIG and National Committee for Quality Assurance (NCQA) recommend at least monthly monitoring of every individual and entity they do business with for federal and state exclusions. This list typically includes:

• Employees 
• Providers (whether employed or contracted, par or non-par)
• Referring and ordering physicians 
• Vendor entities
• Vendor owners