Robert Liles

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 under Section…

Massachusetts Medicaid Exclusion Screening Requirements

Massachusetts Medicaid Exclusion Screening: Requirements and Best Practices for Compliance The Massachusetts Medicaid Exclusion requirements, under MassHealth, will not reimburse…

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 of program…

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) is an…

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 service furnished…

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 the Medicare…

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 Secretary for…

Personal Care Service Aides and Attendants Excluded in 2017

(January 22, 2018): With 2017 behind us, it can be quite helpful to review the Medicare “exclusion” actions taken by the…

Dental OIG Exclusions – A Review of 2017 Actions.

(January 12, 2018):  The Medicare and Medicaid programs are both essential, yet costly health benefit programs sponsored in whole or…

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 complaint or…