OIG Semiannual Report to Congress: Fall 2018-Spring 2019
The Office of Inspector General (OIG) recently published its Semi-Annual Report to Congress covering from October 1, 2018…
Category Exclusion Screening
Exclusion screening is the federal and state compliance obligation to verify that healthcare employees, vendors, and contractors are not barred from participating in Medicare, Medicaid, or other federally-funded programs. Every healthcare provider that bills a federal program is required to screen upon hire and monthly thereafter against the OIG LEIE, GSA/SAM, and all 44 state Medicaid exclusion lists. Failure to screen exposes providers to civil money penalties of up to $24,947 per violation, overpayment liability, and potential False Claims Act exposure. This section of the site is the definitive hub for exclusion screening compliance: the pillar guides, state-by-state requirements, enforcement trends, and the regulatory framework explained by the former federal prosecutors who built it.
Read MoreOIG Semiannual Report to Congress: Fall 2018-Spring 2019
OIG Enforcement Actions: Notable Decisions from March 2019
(April 2, 2019) The Department of Health and Human Services (HHS), Office of Inspector General (OIG), has continued…
February Recap of OIG Enforcement Actions: Notable Decisions
(March 1, 2019) The Department of Health and Human Services (HHS), Office of Inspector General (OIG), has continued…
What to Know About the New CMS Preclusion List
Beginning April 1, 2019, the new CMS Preclusion List will go into effect subsequently barring many healthcare professionals…
A Review of OIG Enforcement Actions in Fiscal Year 2018
By Cason Liles (February 6, 2019): The Department of Health and Human Services (HHS), Office of Inspector General (OIG)…
OIG Enforcement Actions: Notable Decisions from January 2019
(February 6, 2019) The Department of Health and Human Services (HHS), Office of Inspector General (OIG), didn’t skip…
A Provider’s Guide to Texas Medicaid Exclusions: Exclusion Screening Requirements and Best Practices for Compliance
(December 17, 2018): Texas Medicaid Exclusions will prevent the Texas Medicaid Program from paying for any item or…
OIG Exclusion Case Study: The Impact of a False Claims Act Judgment.
(August 23, 2018): In 2008, after learning that a Texas-based laboratory services company was submitting false claims to…