Compliance Q&A
Published August 23, 2016
Q: What is an Exclusion and why do I need to search the OIG Exclusion List?
A:
- President Obama put into place a comprehensive health insurance reform, as part of the Affordable Act, that will change the way healthcare is delivered for the foreseeable future.
- As a part of these changes, The Office of the Inspector General (OIG) imposed and maintains a list of exclusions under the authority of sections 1128 and 1156 of the Social Security Act.
- By law it is the health care provider’s responsibility to self-disclose if you identify an excluded health care provider, staff and vendor. To avoid the negative effects of employing an excluded individual or entity, health care providers should continually search the OIG exclusion list.
- Federal health care programs may not pay, directly or indirectly, for items or services furnished, ordered, or prescribed by excluded individuals or entities.
What this means for you
In response to this exclusion requirement, The Centers will be conducting monthly exclusion checks. Exclusion Information Session Webinars will be conducted in August. Additional information will be shared with all division Administrators.