In-Depth Articles

A State Conviction for “Patient Neglect” Will Result in Mandatory Exclusion from Participation in Federal Health Benefit Programs 

A State Conviction for “Patient Neglect” Will Result in Mandatory Exclusion from Participation in Federal Health Benefit Programs (March 27, 2020):  The Department of Health and Human Services (HHS), Office of Inspector General (OIG) may be required by law under Section 1128 of the Social Security Act to exclude individuals and entities from participating in Federal… more>>

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 take. Each case with a conformed exclusion is fact-specific, there is no “rubber-stamp” approach to this problem. This article discusses and outlines possible paths that can be taken by entities after finding a confirmed exclusion. Review of Exclusions“Exclusions”… more>>

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 any item or service furnished directly or indirectly by individuals or entities that have been excluded from any State or Federal health care programs. This broad “Payment Prohibition” is enforced by the Massachusetts Executive Office of Health… more>>

A Provider’s Guide to OIG Exclusions: Part 2

Federal Exclusion Regulations and Enforcement Authorities, and How Providers Can Avoid Risk with Proper Exclusion Screening–Part 2Paul S. Weidenfeld, JDThis article was originally written by Paul Weidenfeld and published by GreenBranch Publishing.  This article is Part 2 from a 2-Part article originally published by GreenBranch Publishing on their website.Office Inspector General of (OIG) exclusions are… more>>

Can a Medicare Provider or Supplier Hire an Excluded Individual or Enter in a Contract with an Excluded Entity?

(October 9, 2019):  Should you choose to participate in the Medicare and / or Medicaid programs, you must comply with a wide variety of program integrity requirements. One obligation in particular is often missed by physician practices, home health agencies, hospices and laboratories – the “screening” of employees, contractors and agents to ensure that the… more>>

A Provider’s Guide to OIG Exclusions

A Provider's Guide to OIG ExclusionsFederal Exclusion Regulations and Enforcement Authorities, and How Providers Can Avoid Risk with Proper Exclusion Screening--Part 1Paul S. Weidenfeld, JDThis article was originally written by Paul Weidenfeld and published by GreenBranch Publishing.  This article is Part I from a 2-Part article originally published by GreenBranch Publishing on their website.Office of… more>>

Alabama Exclusion Screening Requirements

(May 2, 2019) The Alabama Medicaid Program imposes significant exclusion screening requirements on its providers.  Many are unaware of the extent of their exclusion screening obligations or of the severe consequences that can result from a failure to properly screen.  This short summary has been prepared to help further provider awareness of the exclusion screening rules… more>>

Pennsylvania Exclusion Screening Requirements

 (May 30, 2019)  In August, 2011, the State Department of Public Welfare issued a bulletin requiring providers to screen employees and contractors upon hire and monthly thereafter by the (Medicheck) Pennsylvania Exclusion List (their corresponding State exclusion/preclusion list), the HHS/OIG List of Excluded Individuals and Entities (LEIE) and the Excluded Party List (EPLS, now the… more>>

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