Case Study: Home Healthcare Service Company Resolves OIG Exclusion Investigation with ProviderTrust

Enhanced Data Leads to HHS OIG Dropping an Exclusion Investigation

Home Healthcare Service Company, a national post-acute home healthcare provider operating across 16 states, needed a more reliable way to monitor exclusions and licenses for its 26,000+ employees and care providers. The company had missed a long-active Texas Medicaid exclusion because prior screening was based only on the employee’s original name, even though she had changed her name before hire. ProviderTrust helped identify the issue and support the client’s review of how the exclusion had been missed.

ProviderTrust implemented its Passport system and smarter monitoring protocol, using enhanced primary source data, advanced matching algorithms, and human verification to improve exclusion screening and license verification. The client self-disclosed to Texas, which accepted repayment of Medicaid monies without punitive multiple and closed the matter; the OIG then dropped its investigation with no further action. Since implementation, ProviderTrust has delivered 23 matched, verified exclusions, 429 state sanctions, 382 licensure issues, and 41 SSDMF results across the client’s workforce.