Exclusion News

OIG’s New “Data Analysis Project”– Has OIG Released its own RAC/ZPIC?

stacks of books data analysis project

   Exclusion Screening, LLCSM keeps a close eye on the Department of Health and Human Services Office of the Inspector General’s (OIG) exclusion enforcement action.  Recently, we noticed alarming new language that describes how an exclusion violation came to the OIG’s attention. Specifically, the OIG stated that it identifies excluded individuals through “data analysis projects.”… more>>

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 Office of the Inspector General’s (OIG) enforcement actions as they relate to exclusion violations. As a broad overview, in 2014 HHS-OIG imposed $10.54 million in Civil Monetary Penalties (CMPs) on providers that “knew or should have known” one… more>>

OIG Trumpets Exclusions, New Actions and Recoveries in its Semi-Annual Report to Congress

I.  OIG Report In the Office of the Inspector General's (OIG) semiannual report to Congress, it claimed credit for excluding 2,297 individuals and entities from Medicare, Medicaid, and other Federal health care programs. The OIG also claimed credit for initiating 506 criminal and 267 civil actions. According to the OIG report, most of the exclusions resulted from convictions for crimes… more>>

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, hospice, or nursing and rehabilitation facilities. The Civil Monetary Penalties (CMPs) imposed in these cases range from $10,000 to $428,935 for employing just one individual that the employer knew or should have known was excluded… more>>

Prevention of Grant Awards to Excluded Persons and Entities added to OIG 2015 Work Plan

  I. 2015 OIG Work Plan The Office of Inspector General’s (OIG) ongoing concern regarding exclusion enforcement is reflected in its 2015 OIG Work Plan. In the work plan, the OIG announced that its Office of Audit Services will study whether the operating divisions within its own agency have been taking adequate precautions to ensure that excluded or… more>>

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