decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
OIG Special Advisory Bulletins / OIG Special Advisory Bulletin 99-2_Sept 28, 1999 / Exclusion From Federal Health Care Programs
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Article Overview
This OIG Special Advisory Bulletin addresses how exclusion from federal health care programs affects reimbursement across different payment methods and operational settings. It is relevant to compliance, billing, and reimbursement professionals, as well as providers and suppliers that work with potentially excluded individuals or entities. The article discusses the scope of the federal payment prohibition, the types of work and services that may be implicated, and the compliance implications for organizations that employ or contract with excluded parties.
Why This Topic Matters
Understanding exclusion policy is essential for avoiding improper federal program payments and related compliance exposure. The bulletin helps organizations recognize broad risk areas across clinical, administrative, and supply-chain functions that may involve excluded individuals or entities.
What You Will Learn
- How OIG exclusion affects federal health care program payment
- Which broad categories of services and functions may be implicated by exclusion
- How exclusion risk can arise in both direct care and administrative settings
- Why organizations need to consider employee, contractor, and supplier relationships in exclusion compliance
Who Should Read This
- Healthcare compliance officers
- Medical billers and coders
- Revenue cycle professionals
- Providers and practice managers
- Hospital and nursing home administrators
- Pharmacy and supplier compliance staff
Codes Discussed
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