Fraud Detection & Compliance

FACIS® Fraud & Abuse Control Checks

Comprehensive Fraud and Abuse Control Information System (FACIS®) screening to identify excluded individuals and entities. Ensure regulatory compliance and protect your organization from fraud risks in healthcare and government contracting.

Critical Compliance Requirement: 24-48 hour turnaround for comprehensive FACIS® screening

Federal regulations require regular screening to avoid severe penalties and fines

FACIS® Compliance Screening

FACIS® (Fraud and Abuse Control Information System) is the industry standard for screening healthcare providers, employees, and contractors against federal and state exclusion lists. Failure to conduct proper screening can result in severe penalties, fines, and exclusion from federal healthcare programs.

Exclusion Categories

Types of exclusions and sanctions monitored in FACIS® database

🔴

Mandatory Exclusions

Minimum 5 years

Federal requirements for automatic exclusion

Examples: Felony convictions related to healthcare

🟡

Permissive Exclusions

Varies by case

Discretionary exclusions by OIG

Examples: License revocation, fraud, kickbacks

🔵

State Exclusions

State-specific

State Medicaid program exclusions

Examples: State licensing board actions

🟣

Federal Debarment

Typically 3 years

Exclusion from federal contracts

Examples: Contract fraud, false claims

FACIS® Screening Services

Comprehensive exclusion and sanction screening services

FACIS® Database Search

Comprehensive search of the Fraud and Abuse Control Information System

  • Medicare/Medicaid exclusions
  • DEA controlled substances violations
  • State licensing board sanctions
  • Federal debarment lists
  • OIG exclusion database

Sanctions & Exclusions

Verification against federal and state exclusion lists

  • SAM.gov exclusion verification
  • OIG LEIE database search
  • GSA excluded parties list
  • State Medicaid exclusions
  • Federal debarment status

Disciplinary Actions

Check for professional disciplinary actions and sanctions

  • Medical license sanctions
  • Professional board disciplinary actions
  • Malpractice history verification
  • Criminal convictions check
  • Civil penalty assessments

FACIS® Database Sources

Comprehensive federal and state exclusion databases

⚠️

OIG LEIE Database

Office of Inspector General List of Excluded Individuals/Entities

🚫

SAM.gov Exclusions

System for Award Management excluded parties list

💊

DEA Controlled Substances

Drug Enforcement Administration violations database

🏥

State Medicaid Exclusions

Individual state Medicaid program exclusion lists

🏛️

GSA Debarment List

General Services Administration excluded parties

📋

NPDB

National Practitioner Data Bank for healthcare providers

Risk Level Assessment

Categorization of exclusion screening results

High Risk

Active exclusion or debarment found

Immediate disqualification required

Medium Risk

Historical exclusion or pending investigation

Further investigation recommended

Low Risk

No exclusions found, minor infractions

Standard monitoring recommended

Clear

No matches in any exclusion databases

Cleared for engagement

Screening Parameters

Essential information required for comprehensive FACIS® screening

Name Verification

Full name with aliases and previous names

SSN & NPI

Social Security Number and National Provider Identifier

License Numbers

State professional license numbers

Date of Birth

Age verification and identity confirmation

Compliance Requirements

Regulatory requirements for exclusion screening

📅

Monthly Monitoring

Ongoing exclusion database monitoring

Monthly
👤

Pre-employment Screening

Screening before hiring or engagement

Before start date
🔄

Re-screening

Periodic re-verification of existing staff

Annually
📝

Contractor Verification

Verification of all contracted personnel

Before contract award

Industries Served

Critical need for FACIS® screening across regulated industries

Healthcare Providers

Provider credentialing and exclusion verification

Pharmaceuticals

Sales representative and medical science liaison screening

Medical Devices

Manufacturer and distributor compliance verification

Health Insurance

Provider network credentialing and compliance

Government Contractors

Federal contractor eligibility verification

Research Organizations

Principal investigator and research staff screening

Regulatory Compliance

Ensuring adherence to federal and state regulations

HIPAA Compliance

Adherence to healthcare privacy regulations

Federal Mandates

Compliance with federal exclusion regulations

State Regulations

Adherence to state-specific healthcare laws

Audit Preparedness

Documentation for regulatory audits

FACIS® Screening Report

Comprehensive exclusion screening reports

🚫

Exclusion Status

Current exclusion status across all databases

⚖️

Sanction Details

Detailed information on any sanctions found

🔍

Database Matches

Specific database matches and findings

⚠️

Risk Level

Overall risk assessment and rating

✅

Compliance Status

Regulatory compliance assessment

📋

Recommendations

Actionable recommendations and next steps

Benefits of FACIS® Screening

  • Regulatory Compliance

    Meet federal and state exclusion screening requirements

  • Risk Mitigation

    Avoid penalties and fines for non-compliance

  • Fraud Prevention

    Identify excluded individuals before engagement

  • Reputation Protection

    Protect organization from association with fraud

  • Financial Protection

    Avoid claim denials and financial penalties

  • Continuous Monitoring

    Ongoing protection with regular database updates

24-48
Hours TAT

Comprehensive FACIS® screening process

50+
Databases Monitored

Federal and state exclusion databases

100%
Compliance Coverage

Complete regulatory compliance assurance

Ensure Regulatory Compliance

Don't risk severe penalties and fines. Implement comprehensive FACIS® screening to identify excluded individuals and protect your organization from fraud and abuse risks.