What is an Exclusion Waiver and Who May Apply for one?
We have previously discussed that once a provider is excluded he may not furnish items or services paid for by the…
Why Do I Need a Compliance Hotline?
One of the seven steps to an effective compliance plan is to develop effective lines of communication. While it is…
Recent Developments on the 60-day Rule and the Potential Impact on Exclusion Violations
The Affordable Care Act (ACA) creates a 60‑day window to report and return overpayments from Medicare or Medicaid after the…
2014 In Review – OIG Crack Down on Exclusion Violations
I. CMPs doubled in OIG Exclusion Violations 2014 Exclusion Screening, LLCSM dedicates a significant amount of time to examining the…
Student Loan Default Becoming a Top Reason for Exclusion
Providers are often surprised to learn that a person can be excluded from participation in federal health care programs because…
Home Health and Nursing Home Facilities a Major Target for OIG Enforcement
I. Civil Monetary Penalties Twenty-five out of the fifty-five exclusion enforcement actions reported in 2014 have occurred in home health,…
The Administrative Process of Imposing an OIG Exclusion
I. Mandatory OIG Exclusions When the Office of Inspector General (OIG) considers imposing a mandatory exclusion, it sends the individual…
Alert to Florida Providers Regarding Screening
I. Florida’s State Exclusion. Excluded Providers Costs OIG Over 2.7 Million The Office of the Inspector General (OIG) recently released…
CMS Finds Fault with Exclusion Information Sharing Between States
I. Take It from CMS: If You’re Excluded in One State, You’re Excluded in All States Section 6401(b)(2) of the…