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The ProviderTrust Blog

Your source for healthcare compliance news, advice from industry experts, and all things related to OIG exclusions.

OIG, Fraud and Abuse, exclusions, OIG Exclusion, exclusions list

Seven Things You Might Not Know About OIG Exclusions

Posted by Michael Rosen, ESQ on Tue, Feb 14, 2017

If you work in health care, you are certainly no stranger to the terms “OIG “ and “exclusion.” In fact, you have likely had a nightmare or two on the subject, especially if you work in compliance. While the terms are a hot topic in the health care industry, there is still a lot of mystery surrounding the OIG exclusion process and what is "OIG exclusion list."

Keep reading to discover 7 not-so-obvious things you should know about OIG exclusions:

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OIG Exclusion List, OIG, Fraud and Abuse, Penalties and Fines, OIG Exclusion

NOTICE: New OIG Exclusion Authority for Fines and Penalties

Posted by Michael Rosen, ESQ on Tue, Jan 24, 2017

Hey, we don't want to exclude you from the news, so here is the skinny. The OIG has new and expanded exclusion authorities, and as we will outline below, the fines have increased, in some cases double since last year. The Final Rule effective date is February 13, 2017.

On December 6, 2016, the U.S. Dept. of Health and Human Services, Office of Inspector General (OIG) issued rules that incorporate new civil and monetary fines and penalties (CMP) authorities, clarify existing authorities, and reorganize regulations regarding CMP’s. The Final Rule also implements provisions of the Affordable Care Act (ACA) of 2010 that authorizes CMP’s for:
  1. Failure to grant the OIG timely access to records
  2. Ordering or prescribing while excluded
  3. Making false statements, omissions, or misrepresentations in an enrollment application
  4. Failure to report and return over payments, and
  5. Making or using a false record or statement that is material to a false of fraudulent claim
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OIG Exclusion List, OIG, exclusion list, exclusion, OIG Exclusion

Exclusion List Update! Hey Doc, Is That YOUR John Hancock?

Posted by Michael Rosen, ESQ on Thu, Jan 05, 2017

Exclusion Update!

12-09-2016
NY Physician Agrees to 5 Year Exclusion

On December 9, 2016, Dr. Michael Esposito agreed to be excluded from participation in all Federal health care programs for a period of five years under 42 U.S.C. § 1320a-7(b)(7). The OIG's investigation revealed that Dr. Esposito forged the signature of another physician on prescriptions for medications for himself and another person that were paid for by the Medicare program.

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OIG, Penalties and Fines, exclusions, OIG Exclusion

How to Get Off the OIG Exclusion List

Posted by Michael Rosen, ESQ on Tue, Jan 03, 2017

You just found out you're excluded. Your name is posted on the OIG's List of Excluded Individuals and Entities (LEIE), and the exclusion is following you around like a Scarlet Letter wherever you go, preventing you from working for or with any healthcare company that bills Medicare/Medicaid. 

Now, what?

What exactly is the process for excluding individuals/entities?

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OIG Exclusion List, OIG, exclusions, compliance, OIG Exclusion, compliance program

The Best of 2016: Resources Just in Time for the New Year!

Posted by Michael Rosen, ESQ on Thu, Dec 29, 2016

ProviderTrust 2016 Resources

It's been a wonderful, busy year! There were many changes that took place in healthcare and more specifically, compliance. As we faced those challenges, we partnered with many of you to walk through those changes and ultimately, learn how to serve your compliance programs even better. 

We understand that new regulations effect how you perform you're job and the quality to which you do that work. It is very difficult to study, learn, and implement the changes in a timely manner, especially when it takes additional work on top of what you already do in order to keep up. 

Who has time for that? Well, we do! In this blog, we've got our best resources from 2016 - all in one place!

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