Powering the Next Generation: Streamlining Onboarding for Healthcare’s New Graduates
It’s that time of year when the healthcare field experiences a vital influx of new talent, fresh from recent graduations. This wave of emerging professionals is indispensable for addressing persistent staffing shortages and upholding the highest standards of patient care for the future. Consequently, delivering an optimized onboarding experience is not merely beneficial—it is critical for both your organization’s operational continuity and the successful integration of these new healthcare professionals. As your team prepares to welcome these graduates, the sheer volume can pose significant challenges, even for the most seasoned onboarding teams. To facilitate a seamless and efficient transition during this period, consider these 6 tips for your onboarding processes. Tip #1: Proactive Planning Commence preparations well in advance to create a frictionless experience for both your existing team and the new graduates, many of whom are navigating a hospital or health system’s onboarding processes for the first time. Leverage the pre-surge period to meticulously review internal processes for new graduates, making certain every team member involved in onboarding is proficient in your systems and protocols. Address anticipated frequently asked questions proactively to minimize errors and standardize information delivery. This foresight in identifying and mitigating common roadblocks will yield substantial time savings and reduce potential frustrations for all stakeholders. Tip #2: Assign Dedicated Onboarding Coordinators Navigating the complexities of onboarding in any new role, particularly within a healthcare organization, presents inherent challenges. Where feasible, assign a dedicated onboarding coordinator to new graduates at the outset of their journey. This individual will serve as a consistent point of contact throughout their onboarding experience. A singular point of contact not only alleviates new hire anxiety but also cultivates a more personalized integration into your organization. Furthermore, it promotes a more equitable distribution of workload among your team, enhancing overall efficiency. Tip #3: Communicate Expectations & Timelines Clearly with New Grads From the outset, establish clear guidelines regarding required documentation, critical deadlines, and the paramount importance of maintaining compliance and a clear-to-work status. Tailor onboarding materials to this new audience, making sure all instructions are unequivocally clear and comprehensive, supported by readily accessible points of contact and support channels at each stage. This is an opportune moment to critically evaluate your existing processes and identify areas prone to confusion. Utilize automated reminders and secure portals to facilitate the effortless upload and tracking of documents by new hires. Transparently communicate all deadlines to prevent last-minute complications. Tip #4: Leverage Temporary Permits and Provisional Credentials Wisely Many new graduates will commence their roles with temporary licenses or provisional credentials. These short-term authorizations, issued by state licensing boards or regulatory bodies, allow new healthcare graduates to practice while their full, permanent license application is being processed. It is imperative that your team implements a robust system for effectively tracking temporary permits and proactively alerting you when permanent credentials are required. This vigilance is crucial to prevent any professional from providing patient care without valid credentials or from being unexpectedly removed from existing staff schedules. Tip #5: Prepare for Temporary Staffing Needs Unforeseen circumstances can arise, particularly during periods of high-volume onboarding. While early and thorough preparation significantly mitigates delays, unexpected challenges can still surface at any point in a new hire’s journey. Develop comprehensive contingency plans, including provisions for temporary staff or float pools, should any onboarding delays impact critical staffing levels. Tip #6: Power Onboarding with Tech Graduation season often overwhelms manual systems, leading to bottlenecks and inefficiencies. Investing in scalable automation is paramount to smoothly manage surges in hiring volume, allowing your HR team to reallocate their focus to strategic initiatives rather than administrative burdens. See how Propelus’s workforce compliance solutions — EverCheck, Data Solutions, and Immuware — can help you onboard new healthcare talent faster and with greater confidence. New grads can also use CE Broker to track their own CE requirements, access accredited courses, and make their professional journey smoother.
CE Broker by Propelus Joins Forces with Georgia Secretary of State’s Office to Transform Continuing Education Management
JACKSONVILLE, FL – June 17, 2025 – CE Broker by Propelus, a trusted leader in continuing education compliance for more than 20 years, and the Georgia Secretary of State’s Office announced their strategic partnership to transform continuing education management in Georgia. This collaboration marks a pivotal step in transforming continuing education management for more than 400,000 licensed professionals in Georgia, streamlining departmental processes to improve efficiency and provide more user-centric government tools to support licensure compliance, and ultimately better meet the needs of the state’s professionals. “It’s extremely important to my office that we keep Georgia’s licensed professionals up-to-date on their licensing needs while ensuring that licensure compliance never gets in the way of letting them do their jobs,” said Georgia Secretary of State Brad Raffensperger. “The CE Broker solution from Propelus will keep Georgia’s hardworking professionals in compliance with their specific industry requirements and let them know that my office means business.” CE Broker and the Georgia Secretary of State’s Office have formed a partnership to modernize the continuing education experience for Georgia’s professionals. With CE Broker’s innovative solution, professionals will be able to effortlessly track their continuing education requirements for licensure renewal, quickly identifying any gaps and streamlining the entire renewal process. This collaboration is set to simplify the management of renewal requirements, equipping professionals with the tools they need to efficiently and effortlessly manage their licensing obligations. This partnership aligns with and complements Senate Bill 125, recently passed during the 2025 Georgia legislative session and signed into law by Governor Brian Kemp on May 9, 2025. Under this new law, all licensed professionals will be required to submit proof of continuing education completion prior to license renewal. This change is designed to improve government efficiency, strengthen public protection, and promote safer services across communities in Georgia. “We commend the Georgia Secretary of State’s Office for its ongoing commitment to innovation and the modernization of key processes,” said Julie Walker, CEO of Propelus. “This collaboration reflects our mutual dedication to enhancing public safety, empowering licensed professionals and promoting access to high-quality services for the citizens of Georgia through effective licensure, regulation, and education.” The integration of the CE Broker solution into the GOALS licensing system, a Salesforce solution, is set to begin in June 2025. The Georgia Secretary of State’s Office will notify professionals via email when access to CE Broker becomes available. At that time, professionals can create their accounts at www.cebroker.com using their Georgia license credentials. Those who already have a CE Broker account in another state will be able to easily add Georgia to their profile once it’s available, allowing them to report continuing education across multiple jurisdictions. For more information about CE Broker, visit https://propelus.com/ce-broker. About CE Broker by Propelus As part of Propelus, CE Broker is modernizing how professionals, their employers, regulators, and associations work better together. For over 20 years, CE Broker has propelled the progress of millions of dedicated professionals along the career journey through its full-lifecycle continuing education management solution. Leveraging innovative technology, essential data, and unparalleled strategic partnerships, we power critical compliance programs for a happier workforce, better operations, and safer communities. Learn more about CE Broker, powered by Propelus, at: https://propelus.com/ce-broker Newswire Press Release
May Government Relations Update: Key Developments in Telehealth, Compacts, and State Legislation
Key May updates in telehealth, licensing compacts, and state laws impacting healthcare—insights from Propelus Government Relations.
Beyond the Call: One Nurse’s Inspiring Journey as a DAISY Nurse Leader Award Nominee
In celebration of Nurses Month, Propelus was privileged to interview Tiffany Banks, Director of Nursing at Baptist Health Lexington and a DAISY Nurse Leader Award 2024 nominee. This award, from The DAISY Foundation, honors nurse leaders who demonstrate extraordinary compassion and skill. Tiffany’s 18-year nursing journey, which she shared with us, is a powerful example of leadership that puts people first. While her initial focus was on patient care, her career evolved, marked by her willingness to embrace new challenges. Her acceptance of the nurse manager role, despite initial hesitation, speaks to a mindset of continuous improvement – a drive to grow and make a greater impact. What stands out in Tiffany’s story is the emphasis she places on the influence of mentors and the power of belief in one’s potential. This resonates deeply with the idea of engaging mindfully and meaningfully. She highlights the importance of supportive relationships and their role in shaping her leadership approach. Tiffany’s leadership philosophy centers on creating a supportive environment for her team. This is life-centricity in action – recognizing the importance of the well-being of the individual. This approach has led to significant achievements, such as the impressive reduction in hospital-acquired pressure injuries (HAPIs). This success stemmed from empowering her team, demonstrating her commitment to achieving positive outcomes. The DAISY Award nomination is a testament to the impact of Tiffany’s leadership. Her colleagues emphasize her accessibility, support, and ability to foster a culture of trust and compassion. These qualities reflect a leader who is truly doing what is right and good. In our interview, Tiffany provides valuable insights on: Her path to leadership and its evolution. How she empowers her team to drive change. The critical importance of work-life balance for nurses. Her vision for the future of nursing leadership. Tiffany’s journey underscores the profound impact of leadership rooted in compassion, empowerment, and a dedication to positive change. We invite you to watch the full interview to hear Tiffany’s inspiring story and gain valuable perspectives on leadership and the nursing profession. Want to thank a nurse? We’ve created downloadable thank you cards for you to share with a nurse you admire. Let them know their hard work doesn’t go unnoticed!
Tips and Tools for New Nurses
Adjusting to a new career is a significant step, and in nursing, the transition is unique. Unlike many other professions, new nurses often find themselves immediately immersed in the demanding hospital environment. Long shifts, dynamic schedules, and the constant responsibility of patient care can feel overwhelming. But here’s the good news: you’re not alone. We understand the challenges you face, and we’re dedicated to ensuring you feel prepared, confident, and supported as you embark on this vital career. Think of us as being right there with you, saying, “We got you.” With insights and resources focused on your success, safety, and well-being, we aim to make your transition a smooth and positive one. This blog will guide you through what to expect in your first month, offering crucial success strategies, essential tools for your initial days, vital self-care advice, and key professional development resources. Propelus – and our suite of solutions (CE Broker, EverCheck, and our Data Solutions) – is here to help you confidently move from the classroom to making a real difference in patient care. What New Nurses Bring to the Team Your nursing education and clinical rotations have laid a strong foundation, providing you with practical experience in the hospital setting and patient care. These experiences are invaluable as you begin your career. The pace at which your responsibilities grow will depend on the healthcare facility’s needs and structure. Ideally, your first week will involve crucial onboarding processes, including understanding policies and procedures. Many organizations offer a nursing orientation to help you acclimate to their specific environment. This often includes in-depth training on electronic health records and opportunities to practice using the system. You’ll likely be paired with a mentor or preceptor – someone dedicated to supporting you and answering your questions during this initial phase. As your first month progresses, those initial nerves should begin to ease, and you’ll develop the confidence to take on more independent responsibilities. From monitoring vital signs and assessing patient conditions to administering medications, documenting care accurately, communicating effectively with the healthcare team, and providing essential patient support, you are equipped to make a meaningful impact. We’re here to support you every step of the way, ensuring you feel secure and ready. 6 Keys to Thriving as a New Nurse The fast-paced and demanding nature of nursing is well-known. Fortunately, these strategies can help you not just survive but thrive as you begin your professional journey. We’re in your corner, offering these tips to help you navigate this new chapter. 1. Build Connections Through Respect and Professionalism Every successful healthcare team relies on strong communication and positive relationships. As a new nurse, your daily interactions will involve a diverse group of professionals. Introducing yourself clearly, remembering names, and offering a respectful and professional demeanor are fundamental to building trust and rapport. These connections will not only make your transition smoother but also contribute to a more supportive patient care environment. We believe in the power of connection, and we know you’ll build strong ones. 2. Lean on Experienced Guidance for Support and Growth Finding a mentor early in your career is invaluable. An experienced nurse can offer practical advice, share insights into best practices, help you navigate challenging situations, and guide your professional growth. This mentorship can provide crucial support in balancing your personal and professional life while achieving your career aspirations. Seek out a mentor who understands the demands and rewards of nursing – someone who’s been there and can offer a guiding hand. 3. Prioritize Clarity for Optimal Patient Care Asking questions is not a sign of inexperience; it demonstrates a commitment to providing safe and effective care. In healthcare, clarity is paramount. Never hesitate to ask for clarification on procedures, medication administration, or any aspect of patient care you are unsure about. This proactive approach is crucial for preventing errors and ensuring the best possible outcomes for your patients. We’re here to say, it’s okay to ask – it shows you care. 4. Double-Check Everything for Accuracy and Confidence In the healthcare setting, accuracy is non-negotiable. From documenting vital signs to administering medications, double-checking all information is essential for patient safety. Remember that hospital policies and procedures can vary, so always verify information to prevent inconsistencies and potential errors. This meticulous approach will build your confidence and ensure you’re providing the best possible care. 5. Master Time Management for Efficient and Focused Care Delivery Effective time management and task prioritization are critical in the busy healthcare environment. As you manage multiple patients, organizing tasks based on urgency and importance is vital. Prioritizing patients with immediate needs and time-sensitive tasks ensures that all patients receive timely and appropriate care. Efficient time management will help you feel more in control and less overwhelmed. 6. Invest in Continuous Learning and Maintain Your Credentials Your nursing education doesn’t end with graduation. The healthcare field is constantly evolving, with new research, technologies, and best practices emerging. Pursuing specializations and earning certifications demonstrates your dedication to excellence and your commitment to providing the highest quality care. Remember to stay proactive in maintaining these credentials to ensure ongoing growth and competence. CE Broker by Propelus, our compliance management platform, can help. CE Broker simplifies continuing education (CE) tracking and management for licensed professionals, as well as offers personalized and automated solutions for monitoring renewal requirements, completing courses, and reaching compliance with confidence. In addition to providing essential CE courses, CE Broker’s Credential Tracker allows professionals to stay on top of their certification without the stress of manual tracking or missed renewal deadlines. EverCheck and our Data Solutions also verify and manage a wide range of certifications to healthcare organizations ensure their nursing teams are prepared. 5 Essential Tools for Your First Day: Prepared for Success Comfortable, Slip-Resistant Shoes Long shifts demand comfortable and supportive footwear. Investing in slip-resistant shoes is crucial for your well-being, reducing fatigue and the risk of accidents. Look for durable and
How workforce compliance solutions improve employee experience in a digital-first world
In collaboration with Becker’s Healthcare. The healthcare industry is facing enormous workforce challenges, with the average hospital turning over 106% of its workforce in the last five years. Such high turnover has staggering cost implications. Among those costs are expenses related to credential compliance. And if the urgency to recruit new employees causes organizations to make any mistakes related to credentialing compliance, fines from the Centers for Medicare & Medicaid Services (CMS) can further elevate those costs. During a featured session at the Becker’s Healthcare Human Resources + Talent Virtual Event sponsored by Propelus, Julie Walker, CEO of Propelus, moderated a discussion with Warren Mott, VP for HR service delivery and technology at Ochsner Health (Jefferson, La.), and Valerie Wiegele, director for regulatory assurance at Providence (Renton, Wash.). The panel discussion – called Enhancing the employee experience: Navigating HR & workforce compliance in the digital world – centered on strategies for transforming compliance processes in ways that remove friction and improve the employee experience. Read full article on Becker’s Hospital Review. Watch on-demand panel recording, “Enhancing the employee experience: Navigating HR & workforce compliance in the digital world”.
Setting a New Standard for Primary Source Verification: Expert Insights from Propelus and MedTrainer
The healthcare industry is facing a rapidly changing regulatory landscape, and it can be difficult for organizations to keep up with the latest requirements. One critical part of workforce and provider compliance is Primary Source Verification (PSV), which is the process of directly verifying the credentials of healthcare professionals at a primary source, like a licensing board or other entity. In a recent webinar, Joyce Siow-Yazzie, credentialing solutions consultant at MedTrainer, and Julie Walker, CEO at Propelus, discussed the new standard for PSV and how organizations can improve their processes to meet the new standard needed for PSV. Why is PSV More Challenging Now? Walker and Siow-Yazzie shared that several factors make PSV more challenging now than before. These include: Difficulty accessing data Managing the increasing volume of healthcare data The complexity of the verification process Evolving regulations Fraud and misrepresentation Need for continuous compliance monitoring What is the New Standard for PSV? The speakers shared that the new standard for PSV is on-demand automation, verifications from the original source, image capture, pricing predictability, continuous monitoring, and unparalleled board-level partnerships. How Can Organizations Level Up to This New Standard? Walker and Siow-Yazzie recommended several ways organizations can level up to this new standard. Those include: Checking licenses on-demand and continuously – using technology to automate verifications and stay current; Leveraging technology – implementing software solutions that streamline the PSV process; Collaborating with CVOs – partnering with Credential Verification Organizations (CVOs) for expertise and resources; and Establishing robust data analysis and monitoring practices – identifying and addressing potential issues early. What Does the Partnership Between Propelus and MedTrainer Mean for Customers? The MedTrainer and Propelus partnership revolutionizes provider credentialing by supercharging MedTrainer’s platform with Propelus’s industry-leading data capabilities, allowing customers to achieve a new standard of workforce and provider compliance. They can say goodbye to manual verifications, inaccurate or incomplete verifications, and static provider verifications. They can also welcome on-demand automation, continuous monitoring, and near real-time intelligence. Conclusion Industry changes and expectations are forcing a new standard for PSV. However, the speakers highlighted that by leveraging technology and partnering with the right providers, organizations can improve their processes and ensure compliance. Watch the Full Webinar To learn more about the new standard for PSV, watch the full webinar on-demand here.
Heart Smarts: Equipping Professionals to Support Cardiovascular Health
February is American Heart Month—a time to raise awareness about heart health and cardiovascular diseases. It’s also a time to recognize the critical role healthcare professionals play in supporting cardiovascular health and interventions. Heart disease remains the leading cause of death in the U.S., making it essential for providers to stay up-to-date with the latest knowledge, skills, and credentials. 1 At Propelus, we help ensure they do. Through EverCheck, CE Broker and our Data Solutions, we equip healthcare organizations with the tools to maintain compliance, streamline credential management, and keep their teams focused on what matters most—patient care. The Credentials that Save Lives In a cardiovascular emergency, every second matters. Healthcare professionals must have up-to-date certifications to provide lifesaving cardiac care, and organizations need a reliable way to track and verify these credentials. EverCheck streamlines the process helping healthcare organizations ensure their teams are prepared. EverCheck and our Data Solutions verify and manage a wide range of cardiac care and resuscitation certifications, including: American Heart Association (AHA) Certifications: Advanced Cardiac Life Support (ACLS), Basic Life Support (BLS), Pediatric Advanced Life Support (PALS), Heartsaver® CPR AED, Pediatric Emergency Recognition and Stabilization (PEARS®) American Red Cross Certifications: Advanced Life Support (ALS), BLS, PALS Resuscitation Quality Improvement® (RQI) & HeartCode® Certifications: RQI Provider eCredential, ACLS HeartCode® eCard, BLS HeartCode® eCard Neonatal Resuscitation Program (NRP) Certifications: Advanced Provider, Instructor Renewal, and more By automating verification, EverCheck and our Data Solutions reduce administrative burdens and ensures healthcare professionals can deliver life-saving care with confidence. Advancing Heart Health Through Education Education is key to managing and treating heart disease. CE Broker makes it easy for healthcare professionals to access relevant continuing education (CE) courses that strengthen their knowledge and improve patient care. Some of the top cardiovascular health-related courses available through CE Broker include: Advanced Cardiovascular Life Support (ACLS) Understanding Heart Failure Emergency Cardiac Care Guidelines Evidence-Based Care for Patients with Acute Heart Failure Cardiovascular Nursing: Interventional Cardiology (Course availability may vary by state and profession.) In addition to providing essential CE courses, CE Broker’s Credential Tracker allows professionals to stay on top of their cardiac care and resuscitation certifications—like CPR, ACLS, BLS, and PALS—without the stress of manual tracking or missed renewal deadlines. The Propelus Commitment At Propelus, we know that credential verification and continuing education are vital components of delivering high-quality patient care. That’s why we make it easier for healthcare professionals and organizations to stay ahead, ensuring that heart health remains a priority. For Heart Month, we are taking it one step further—CE Broker will be donating a portion of proceeds from subscription purchases to the American Heart Association. This means that when healthcare professionals invest in their education and credential management, they are also contributing to heart health initiatives. The Wrap Up Heart Month is more than just a reminder—it’s a time to take action. By making credential management and continuing education seamless, EverCheck, CE Broker and Data Solutions empower healthcare professionals to provide the best possible care for patients. At Propelus, we are proud to equip healthcare professionals with tools to support cardiovascular health. By investing in education and credential management, we are working toward a future where heart disease is no longer the leading cause of death. Let’s work together to power professionals and champion heart health—today and every day. 1. National Center for Health Statistics. Multiple Cause of Death 2018–2022 on CDC WONDER Database. Accessed May 3, 2024. https://wonder.cdc.gov/mcd.html
MedTrainer and Propelus Announce Strategic Partnership to Revolutionize Provider Credentialing
Partnership supercharges provider credentialing software with industry-leading data capabilities LAS VEGAS, Nev., January 14, 2025 – MedTrainer, a leading provider of healthcare workforce compliance solutions, and Propelus, an innovator in dynamic workforce compliance management solutions, today announced a strategic partnership to enhance provider credentialing for healthcare organizations. This collaboration combines MedTrainer’s comprehensive provider credentialing management software with Propelus’s Data Solutions, establishing a new standard for powering provider compliance with on-demand primary source verifications and monitoring. This seamless automation accelerates provider contracting, onboarding, and recredentialing processes to reduce time, ensure ongoing compliance, and maximize revenue. “This partnership immediately supercharges MedTrainer’s cutting-edge credentialing platform with Propelus’s deep and broad data to automate license verifications across all 50 states. The combined capability gives our small and medium-sized customers a streamlined, highly automated, and design-to-fit credentialing solution, which is needed in today’s increasingly complex environment,” – Steve Gallion, CEO of MedTrainer. The partnership between MedTrainer and Propelus delivers several advantages, including: Faster provider onboarding: Automate all types of license verification and credentialing processes, enabling providers to join your organization or network and deliver care more quickly with reduced administrative burden. Improved accuracy: Access comprehensive, reliable, and up-to-date data for primary source verification, minimizing errors and ensuring data integrity. Increased efficiency: Streamline workflows, reduce manual tasks and paperwork, and save valuable time for both providers and administrators. Enhanced compliance: Minimize risk by seamlessly verifying licenses, certifications, and other credential requirements, ensuring adherence to industry standards and regulations. Comprehensive oversight: Access data centrally and leverage robust reporting to maintain information and credentialing status, facilitating better oversight and near real-time decision-making. Maximized revenue: Shortening the initial credentialing timeline reduces lost revenue. On-demand monitoring prevents delays in re-credentialing and the inability to bill for services. “We are honored to collaborate with MedTrainer and our many customers to meaningfully address the growing need for efficient and reliable credentialing solutions in the healthcare industry. Our complementary values-driven approach and commitment to solving healthcare workforce challenges through technology and innovation is our highest priority.” – Julie Walker, CEO of Propelus By combining MedTrainer’s provider credentialing platform with Propelus’s extensive Data Solutions, the partnership sets a new standard for faster, smarter, and more complete provider compliance. Organizations interested in learning more about this enhanced offering can visit https://medtrainer.com/products/credentialing/. About MedTrainer Established in 2013, MedTrainer accelerates and simplifies healthcare workforce compliance. MedTrainer is a natively-built software platform that helps small and medium-sized healthcare organizations save time, reduce risk, and increase revenue through effectively managing workforce compliance. MedTrainer’s all-in-one integrated technology solution delivers credentialing, training, and compliance workflows to manage business critical activities that meet regulatory and industry standards. Backed by Telescope Partners and Vista Equity Partners, MedTrainer is used by over 300,000 healthcare professionals at more than 15,000 healthcare sites across the United States. About Propelus Propelus streamlines workforce compliance management for healthcare. Our innovative technology and strategic partnerships empower millions of professionals and their employers, regulators, and partners to work together, ensuring a better-connected and more efficient healthcare ecosystem. For over 20 years, Propelus has been a trusted leader, providing seamless compliance solutions to millions of professionals. We leverage market-leading technology and essential data to simplify complex operations, reduce risk, and promote a safer, healthier, happier workforce and better communities. Cision PR Web news release
What is a Mandatory Exclusion in the Healthcare Industry?
Protecting patients and employees within the healthcare industry is critical for leaders and healthcare HR professionals. The Office of Inspector General (OIG) must, by law, ensure that individuals and entities who have committed fraud, waste, or abuse can no longer participate in federal healthcare programs, like Medicare or Medicaid. In this blog, we explore what a mandatory exclusion is and the impact it can have on a healthcare organization or individual. We’ll also share some key ways you can work to avoid issues with mandatory exclusion through regular audits and compliance checks. Definition of Mandatory Exclusion Mandatory exclusion is a legal requirement to exclude participation in federal healthcare programs following an individual or entity’s conviction for various criminal offenses. Common reasons for being included on the list include Medicaid or Medicare fraud; fraud related to the State Children’s Health Insurance Program (CHIP), Tricare, or other state programs; patient abuse or neglect; felony convictions for fraud, theft, or other financial misconduct; and felony convictions involving the unlawful manufacture, distribution, prescription, or dispensing of controlled substances. Those organizations or individuals who find themselves on this list cannot receive payment from federal healthcare programs. Keep in mind that you’ll also find permissive exclusions on the list. These exclusions may result from misdemeanor convictions related to healthcare fraud, fraud in a program other than a healthcare program, misdemeanor convictions for the unlawful manufacture, distribution, prescription, or dispensing of controlled substances, or the suspension, revocation, or surrender of a healthcare license due to issues of competence. The term of exclusion usually sits in the one to three-year range for these types of exclusions, compared to five years to indefinite exclusion with mandatory exclusions. Common Contexts for Mandatory Exclusions Mandatory exclusions impact the individual or organization on the list and can put your organization at risk. This impact is why organizations must check the list monthly to avoid finding themselves in legal trouble or at risk for non-reimbursement due to having someone on the exclusions list perform services on behalf of their organization. Exclusions apply to all employees, whether licensed or not, as well as contractors, vendors, and referring physicians. Many state Medicaid bulletins suggest monthly monitoring of ordering and referring physicians, underscoring the importance of regular checks to ensure compliance. Consequences of Mandatory Exclusion You’ll find immediate and long-term consequences if your organization or an individual working within your organization finds themselves on the list. Mandatory exclusion usually results in a minimum of five years on the list, but this can be indefinite depending on the severity of the crime or issue that got you on the list. Professional licenses, certifications, and employment will likely be revoked, leaving you with little choice but to find another type of employment. Your reputation within the healthcare industry will be damaged because of this exclusion, and you’ll find that financial penalties can be imposed on you during the exclusion process. In order to get yourself off the list can be a very long and costly process, with many individuals and organizations finding it impossible to remove themselves from the list following their addition. For employers, the impacts are equally significant. Federal health care programs will not make payments for any items or services furnished, ordered, or prescribed by an excluded individual or entity. The payment prohibition extends to the excluded individual or entity, anyone employing or contracting with the excluded party, and any hospital or other provider for which the excluded party performs services. While there is a limited exception for certain emergency items or services not provided in a hospital emergency room, the broader implications of exclusion pose significant operational and financial risks for employers. Avoiding Mandatory Exclusions To avoid mandatory exclusion, ensure that you always follow the best practices set by the industry and the regulations surrounding state healthcare programs. Compliance checks and regular audits can help you avoid getting on the list yourself and stop you from engaging with anyone on the mandatory exclusion list. Should you find out that someone you employ or work with is on the list, it’s critical that you immediately take action to stop your involvement with them. The list is updated each month, usually in the second week of the month. It’s important that your team gets into the habit of regularly auditing the list and your employees so that you can take action should someone appear on the list. When hiring a company or working with a new employee, review the list before offering them employment or setting up business contracts. These steps protect your organization and its reputation and will help you avoid ending up on the list yourself for fraud or other illegal activities. Conclusion | About Propelus Understanding and avoiding mandatory exclusions is critical for anyone operating a business within the healthcare industry. Propelus can support your efforts. We recently announced the launch of our Exclusions Monitoring API, which provides monthly monitoring of healthcare exclusions and ensures exclusions intelligence is accessible how, when, and where it is needed for more informed, real-time compliance with ease. Additionally, our EverCheck by Propelus solution delivers the most up-to-date primary source data, including exclusions monitoring, so you can have confidence that your workforce is compliant and in good standing. By remaining in compliance, you’ll work to protect your reputation, avoid potential loss of trust, and ensure you also don’t end up on the list in the future.
