NEMT OIG LEIE and SAM Exclusion Screening Log

Monthly inspection log for documenting non-emergency medical transportation (NEMT) screening of drivers and staff against the OIG LEIE and SAM.gov exclusion databases, with hire-date and ongoing monitoring evidence.

Inspection Details

• Inspection month and year recorded
  Record the month being screened and the date the log was completed.
• Screening population identified
  Select all groups included in this monthly screening cycle.
• Screening performed by authorized staff
  Enter the name or role of the person who performed the screening.
• Reference policy or SOP used
  Identify the internal procedure governing exclusion screening and follow-up.
• Monthly screening cycle completed on time
  Confirm the monthly screening was completed for the current cycle without lapse.

OIG LEIE Screening

• All covered individuals screened against OIG LEIE
  Verify each covered driver and staff member was screened against the OIG List of Excluded Individuals and Entities.
• Screening date captured for each individual
  Confirm the date of each LEIE search is documented for audit traceability.
• Search method documented
  Record how the LEIE search was performed.
• No LEIE matches identified
  Confirm no exact or potential matches were found during the screening cycle.
• Potential match resolved and documented
  If a potential match was identified, confirm the resolution steps and outcome are documented.

SAM.gov Screening

• All covered individuals screened against SAM.gov exclusion records
  Verify each covered driver and staff member was screened against SAM.gov exclusion information as part of the monthly cycle.
• Screening date captured for each SAM.gov search
  Confirm the date of each SAM.gov search is documented for traceability.
• Search method documented for SAM.gov
  Record how the SAM.gov search was performed.
• No SAM.gov matches identified
  Confirm no exact or potential matches were found during the screening cycle.
• Potential SAM.gov match resolved and documented
  If a potential match was identified, confirm the resolution steps and outcome are documented.

Hire-Date and Ongoing Monitoring Controls

• Pre-hire screening completed before start date
  Confirm exclusion screening was completed before the individual began covered work.
• Monthly re-screening interval maintained
  Confirm no covered individual exceeded the monthly screening interval without documented review.
• New hires added to screening roster within required timeframe
  Confirm newly hired covered staff were added to the screening roster promptly after hire.
• Terminated or inactive staff removed from active roster
  Confirm the roster reflects current active staff only and excludes terminated or inactive personnel.

Deficiencies, Corrective Actions, and Sign-Off

• Deficiencies documented with affected individuals
  List any deficiencies, missed screenings, or documentation gaps and identify affected individuals.
• Corrective action and follow-up due date recorded
  Document the corrective action taken, owner, and due date for completion.
• Immediate removal from covered duties documented when required
  Confirm any individual with a confirmed exclusion or unresolved potential match was removed from covered duties pending resolution.
• Inspector signature completed
  Inspector signs to attest the monthly screening log is complete and accurate.