December 5, 2016

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Department of Health and Human Services Office of Inspector General Releases Updated Special Advisory Bulletin on Exclusions from Participation in Federal Health Care Programs

Fourteen years after the original bulletin, the Department of Health and Human Services Office of Inspector General (OIG) released an updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs.

The Bulletin details the consequences of exclusion from  federal health care programs and provides guidance for employers. Since the release of the 1999 bulletin, the OIG has received several questions about exclusions, many of which they address in the 2013 update.

The updated Bulletin:

(1). Confirms guidance from the 1999  bulletin on the scope and effect of an OIG exclusion;

(2). Provides additional guidance on the scope of the payment prohibition and potential Civil Monetary Penalty liability;

(3). Provides guidance on best practices for screening against the List of Excluded Individuals and Entities to ensure that providers do not employ or contract with an excluded individual; and

(4). Directs providers to use OIG’s Self-Disclosure Protocol to self-disclose the employment ofor contract withan excluded person.

A notice announcing the bulletin will be included in the May 9 Federal Register publication.



About this Author

The Barnes & Thornburg Healthcare Department regularly represents physicians, medical groups, managed care organizations, hospitals, nursing homes, and national healthcare-related associations located around the country. Given our healthcare practice, we understand the unique commercial and regulatory environment in which healthcare organizations operate. Our attorneys bring their problem-solving and consensus-building skills to listen carefully to the goals of their clients and recommend practical solutions.