Propelus Launches Exclusions Monitoring API to Help Organizations Proactively Detect and Prevent Healthcare Fraud, Waste and Abuse
Following the launch of its Primary Source Verification API, Propelus today announced the launch of its healthcare Exclusions Monitoring API. The Exclusions Monitoring API is part of the company’s data solution offerings and is designed to ensure healthcare providers, payers, vendors, and contractors take appropriate compliance measures to safeguard against fraud, waste, and abuse. The Department of Justice (DOJ) estimates up to $100 billion annually is lost to healthcare fraud, waste and abuse. Individuals and entities who have been involved in fraudulent activities are added to federal and state exclusion lists, which prevent payment from being made to the excluded party, as well as any hospital or other healthcare provider where the excluded party provided services or was otherwise engaged. Additionally, hospitals and healthcare organizations face severe legal consequences, costly civil monetary penalties (CMPs) and fines, and reputational damage when engaging with individuals or entities excluded from federal healthcare programs or government contracts due to previous misconduct resulting in an exclusion. “Healthcare organizations and payers serve an important role in mitigating fraud, waste, and abuse and are responsible for not engaging or paying for any services from any individual or entity that is excluded. Our OIG compliant Exclusions Monitoring API 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.” – Julie Walker, CEO of Propelus. Complementary to the Propelus Primary Source Verification (PSV) API with daily monitoring of over 8,300 licenses, certifications, registrations, sanctions, and more source types, the Propelus Exclusions Monitoring API empowers on-demand, bulk submissions with identity resolution, indexing and reconciling identifiers, and match capabilities to ensure any excluded individual or entity is detected. It delivers the most up-to-date exclusions data through monthly checks against primary sources, while ensuring proper connectivity within the broader compliance management ecosystem for better workforce compliance operations. The Exclusions Monitoring API monitors the following federal and state exclusion lists: HHS-OIG LEIE: Health and Human Services (HHS), Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) GSA SAM: General Services Administration (GSA) System for Award Management (SAM) – the SAM.gov database is formerly known as the GSA list of Excluded Parties Lists System (EPLS). All currently available (45) State Medicaid Exclusions Lists: Many states maintain their own exclusion lists to identify individuals or entities barred from participating in Medicaid programs due to fraud or other violations. For more information about the Propelus Exclusions Monitoring API and how it can support your organization’s workforce compliance efforts, visit propelus.com/api. Newswire Press Release
Propelus Launches Groundbreaking Primary Source Verification API
JACKSONVILLE, Fla., May 14, 2024 – Propelus, a leader in dynamic workforce compliance solutions, is excited to unveil its latest innovation: the Propelus Primary Source Verification (PSV) API. This cutting-edge solution reinforces Propelus’ unwavering commitment to empowering healthcare organizations and professionals and their collective need for far greater connectivity, continuity, and real-time transparency across a broad and complex healthcare ecosystem. With the addition of the PSV API to Propelus’ offerings, customers have on-demand access to the most comprehensive, automated, and accurate primary source verified data–how, when, and where it is needed to ensure a more compliant, safer, and happier workforce in compliance management. “We are honored to help our healthcare partners solve complex workforce compliance problems through game-changing technologies. Our new PSV API simplifies workforce compliance and streamlines healthcare operations at scale, automating more than 4,800 different types of professional license, certification, registration, sanctions, exclusions, and more primary sources at scale to meet our complex healthcare ecosystem’s needs.” – Julie Walker, CEO at Propelus The Propelus PSV API drives workforce compliance effectiveness and efficiency by seamlessly delivering essential primary source data connecting established systems within Human Resources, Talent Acquisition, Medical Staffing Services, Compliance, Finance, and more. Propelus’ customers are thrilled by the addition and continued innovation, which perfectly complements their current workforce compliance offering as a faithful ally in elevating healthcare quality, safety, and outcomes. “The launch of the Propelus PSV API represents a significant milestone in our commitment to revolutionize workforce compliance management,” said John Barnes, Chief Product and Technology Officer at Propelus. “Our API provides unparalleled access to primary source verification data and privileged partner relationships that are powering unprecedented opportunities to streamline total workforce compliance with confidence.” The Propelus PSV API performs millions of primary source verifications daily, providing ongoing insights and an unrivaled workforce compliance management experience beyond keeping pace with regulatory changes, which is something Propelus is passionate about and is no easy feat for healthcare organizations. For more information about the Propelus PSV API and how it can revolutionize your workforce compliance management experience, visit propelus.com. About Propelus: As a leader in workforce compliance technology, Propelus is modernizing how healthcare professionals, their employers, regulators, and partners work better together. For over 20 years, Propelus solutions — CE Broker, EverCheck, and Immuware — have propelled the progress of millions of professionals by providing seamless compliance management throughout their career journey. Leveraging market-leading technology, essential data, and unparalleled strategic partnerships, we power critical compliance programs for a happier workforce, better operations, and safer communities. Learn why Propelus is trusted by 5+ million professionals: https://propelus.com/. Newswire Press Release