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May 21, 2013

House Bill Would Expand OIG’s Exclusion Authority

If passed, the Strengthening Medicare Anti-Fraud Measures Act, introduced on February 11 by Representatives Wally Herger (R-CA) and Pete Stark (D-CA), would expand the OIG’s exclusion authority to address gaps in fraud legislation. The legislation would expand OIG’s permissive exclusion authority to individuals and entities affiliated with sanctioned entities. According to the Representatives’ press release, the proposed legislation closes two important loopholes:

1.      Under current law, executives who have left the company by the time of conviction cannot be barred from federal health care programs. Under the proposed legislation, corporate executives may be banned from doing business with Medicare if their companies are convicted of fraud even after they leave the company.

2.      Under the legislation, parent companies engaging in fraud through shell companies are no longer insulated from liability and may be excluded from participation in federal health care programs.

Representatives Herger and Stark, the Chairman and Ranking Member of the House Ways and Means Health Subcommittee, are joined by nineteen other Representatives in sponsoring the bill. The legislation was introduced and passed in the House last year, but the Senate failed to pass it.

For the text of the bill. visit: http://go.usa.gov/gcH

©2013 von Briesen & Roper, s.c

About the Author

Meghan O’Connor is a member of the Health Care Practice Group. Her practice focuses on general health law including managed care and provider contracting, risk management, and regulatory compliance.

Prior to joining von Briesen, Meghan worked for the Centers for Medicare and Medicaid Services where she consulted with states regarding federal health law, regulation and policy, evaluating managed care contracts and conducting compliance reviews.

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