Exclusion Checks - Chapter 16, 2018 UnitedHealthcare Administrative Guide

Prior to hiring or contracting with employees, you must review federal (HHS-OIG and GSA) and state exclusion lists, as applicable. This includes the hiring of temporary workers, volunteers, the CEO, senior administrators or managers, and sub delegates who are involved in or are responsible for the administration or delivery of UnitedHealthcare MA and Part D benefits or services.

What You Need to Do

  • Make sure that potential employees are not excluded from participating in federal health care programs. For more information or access to the publicly accessible excluded party online databases, please see the following links:
    • Health and Human Services – Office of the Inspector General OIG List of Excluded Individuals and Entities (LEIE) at oig.hhs.gov.
    • General Services Administration (GSA) System for Award Management at SAM.gov
  • Review the exclusion lists every month and disclose to UnitedHealthcare any exclusion or any other event that makes an individual ineligible to perform work directly or indirectly on Federal health care programs.
  • Maintain a record of exclusion checks for 10 years. We, or CMS, may request documentation of the exclusion checks to verify they were completed.