hr profile may 2016 webinar oig-ofac-gsa … sam exclusions exclusions terrorists exclusions ......
TRANSCRIPT
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
Harry Settle
Enterprise Accounts [email protected]
800-969-4300
©Copyright 2016 HR ProFile, Inc. All Rights Reserved
� Welcome!
� Introductions
� Purpose of Presentation
� Content Presentation
� Q & A’s throughout and at end
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©Copyright 2016 HR ProFile, Inc. All Rights Reserved
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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©Copyright 2016 HR ProFile, Inc. All Rights Reserved
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
5/20/2016
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©Copyright 2016 HR ProFile, Inc. All Rights Reserved
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
©Copyright 2016 HR ProFile, Inc. All Rights Reserved
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
Proprietary Database Searches
US Treasury
Private Companies
US GovernmentIndependent Agency
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
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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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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
Proprietary Database Searches
US Treasury
Private Companies
US GovernmentIndependent Agency
HHSHealth and Human
Services
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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
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15General Services Administration - GSA
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16GSA – Violations
Over 115,000 individuals on list
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17GSA – Violations
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Global Watch List
Patriot Search
Sanction Watch
The Patriot Act
SAM – EPLSExcluded Parties List System
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GSA
General Services Administration
Proprietary Database Searches
Private Companies
US GovernmentIndependent Agency
LEIEList of Excluded Individuals
and Entities
OIG
Office of Inspector General
HHSHealth and Human
Services
SDN Specially Designated Nationals
~ Terrorist Watch List ~
OFAC
Office of Foreign Assets Control
US Treasury
5/20/2016
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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
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20Office of Foreign Assets Control - OFAC
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21OFAC Sanctions – SDN’s
OFAC SDN’s List - Compiled from 29 Separate Sanctions Lists
OFAC SDN’s List – Currently 948 PDF PAGES
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22OFAC Violations
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SDN Specially Designated Nationals
~ Terrorist Watch List ~
LEIEList of Excluded Individuals
and Entities
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OFAC
Office of Foreign Assets Control
OIG
Office of Inspector General
US Treasury
HHSHealth and Human
Services
Global Watch List
Patriot Search
Sanction Watch
The Patriot Act
ProprietaryDatabase Searches
Private Companies
SAM – EPLSExcluded Parties List System
GSA
General Services Administration
US GovernmentIndependent Agency
©Copyright 2016 HR ProFile, Inc. All Rights Reserved
Proprietary Database Searches
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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5/20/2016
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PRIMARY SOURCE PROPRIETARY DATABASE
INDUSTRY
Specific
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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?
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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
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
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