When an Underlying Misdemeanor or Felony Conviction is Expunged, Does That Extinguish an Exclusion Action?
Medicare and Medicaid providers / suppliers are prohibited from employing individuals who have been excluded from participation in…
Category Effect of an Exclusion
What happens when a provider, employee, or vendor is excluded from federal healthcare programs. Covers the legal effect of an exclusion, the payment prohibition on all items and services furnished directly or indirectly by excluded persons, and the downstream consequences for providers who employ or contract with them.
Read MoreWhen an Underlying Misdemeanor or Felony Conviction is Expunged, Does That Extinguish an Exclusion Action?
A State Conviction for “Patient Neglect” Will Result in Mandatory Exclusion from Participation in Federal Health Benefit Programs
The Department of Health and Human Services (HHS), Office of Inspector General (OIG) may be required by law…
I Have a Confirmed Exclusion What are my Options
After finding a confirmed exclusion among your employees, vendors, contractors, or volunteers there are several options you can…
Can a Medicare Provider or Supplier Hire an Excluded Individual or Enter in a Contract with an Excluded Entity on the Medicare Exclusion List?
Should you choose to participate in the Medicare and/or Medicaid programs, you must comply with a wide variety…
Health Care Providers Should Consider the Ramifications of “Taking a Plea” in a Criminal Case or Agreeing to a Licensure Action. It May Trigger a Mandatory or Permissive OIG Exclusion Action.
Perhaps the most severe administrative sanction available under the Social Security Act stems from the authority of the…
Reciprocal Licensure Actions Can Lead to Medicare Revocation and Exclusion
(January 8, 2018): Most physicians will progress through their entire career without ever having to respond to a…
The New “Seventh Element” of Compliance: Screening and Evaluating Employee Suitability!
The recently issued Resource Guide for Measuring Compliance Program Effectiveness, reconfigures the traditional formulation of the “Seven Elements…
Home Health Final Rule Extends Exclusion Screening Obligation: Failure to Screen Could Result in Termination from Medicare
By Paul Weidenfeld The new Final Rule issued by CMS revising the conditions of participation for home health agencies…