decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Exclusion / Permissive Exclusion / License revocation or suspension
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Article Overview
This article covers a Medicare and Medicaid exclusion topic focused on professional license loss and OIG permissive exclusion authority. It is relevant to compliance, credentialing, and health care administrative staff who need to understand the broad circumstances that can trigger exclusion review, the general categories of factors that may affect the exclusion period, and the circumstances described for possible early reinstatement.
Why This Topic Matters
License actions can have downstream federal program consequences, so organizations need a clear understanding of when OIG exclusion may apply and what broad issues can influence its duration or reconsideration. The article helps readers assess whether a licensing event may have federal compliance implications.
What You Will Learn
- When OIG permissive exclusion may be considered after a license revocation, suspension, or surrender
- What broad categories of factors may lengthen or shorten an exclusion period
- What general circumstances may support early reinstatement consideration
- How the topic relates to federal program integrity and licensing actions
Who Should Read This
- Health care compliance professionals
- Medical billing and coding staff
- Credentialing and provider enrollment staff
- Health care administrators
- Risk management personnel
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