lahey clinic

Lahey Health, a health system in Burlington, Massachusetts, has selected BESLER’s BVerified – Screening and Verification solution to facilitate compliance with the Centers for Medicare and Medicaid Services’ screening requirements.

According to federal regulations, services rendered by individuals and organisations that have been excluded from federal healthcare programmes due to fraud and abuse convictions will not be eligible for Medicare reimbursement.

If a provider finds that one of its employees or vendors is on the exclusion list, it is required to report this to the CMS.

In such cases, CMS reserves the right to recover payments made to the provider that are directly or indirectly related to that employee or vendor.

While CMS advises hospitals to screen employees and vendors against the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) list of excluded individuals "routinely", industry best practices dictate that providers screen all employees, vendors and caregivers monthly.

BESLER’s BVerified – Screening and Verification is an automated solution designed to help simplify this potentially daunting task.

The software includes all available state Medicaid exclusion databases, additional federal exclusion lists and accessible state licensing databases.

The software addresses several issues that can arise during screening, including name mis-spellings, hyphenated names and recurring false positive matches.

BESLER president and CEO Jonathan Besler said the company is happy that Lahey Health chose its sanctions screening solution.

"We believe our tool’s features and support, combined with our flat pricing model and comprehensive data set, make it an attractive option for providers," Besler added.

Lahey Health includes a tertiary teaching hospital and medical centre, community hospitals, outpatient centres, community physician practices, a network of senior care and home care services and comprehensive community based behavioral health services, serving north-eastern Massachusetts and southern New Hampshire.

Image: Lahey Clinic in Burlington, Massachusetts. Photo courtesy of Richard B. Johnson.