Per the OIG, under the Exclusion Statute, they have the authority to exclude individuals and entities from Federally funded health care programs.
When the individual or entity is excluded, this means they can no longer receive payments from any federal government programs for any items or services they furnish, order, or prescribe.
The following are considered mandatory exclusions under this statute:
What qualifies as a permissive exclusion?
The following are considered permissive exclusions (but not limited to) under this statute:
As stated in our previous tip, the OIG suggests that healthcare entities conduct monthly (routine) checks to ensure all current and new employees are not listed on the OIG, GSA, or state lists. And, they emphasize anyone who hires an individual or entity on the exclusion list (LEIE) may be subject to civil monetary penalties (CMP).
Since this process is time-consuming, hiring vendors to complete the screening is your best option. But, if you still want to oversee this process, you can start by reviewing the OIG’s “Exclusions Program” on their website.
**The opinions and observations from the group/author are not a promise to exempt your practice from fines and penalties. Research, modify, and tailor the advice to fit your specialty.