Exclusions

A Provider’s Guide to OIG Exclusions

A Provider’s Guide to OIG Exclusions: Federal Exclusion Regulations and Enforcement Authorities, and How Providers Can Avoid Risk with Proper Exclusion…

North Carolina Exclusion Screening Requirements

To understand the North Carolina Exclusion Screening Requirements, we must first touch upon Exclusions in general. Office of Inspector General…

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…

Pennsylvania Exclusion Screening Requirements

  (May 30, 2019)  In August, 2011, the State Department of Public Welfare issued a bulletin requiring providers to screen…

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…

What Providers Need to Know About Medicaid Exclusions in Texas: 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…

Exclusion Loophole: Medicaid Managed Care

In August, we discussed an OIG audit, which revealed that Medicaid providers who were terminated for cause were often able…

OIG Issues Advisory Opinion on Exclusions

I.  Advisory Opinion on Payments for Services Provided Prior to Exclusion The Department of Health and Human Services Office of…