decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
OIG Special Advisory Bulletins / OIG Special Advisory Bulletin 99-2_Sept 28, 1999 / Violation of an OIG Exclusion by an Excluded Individual or Entity
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Article Overview
This short OIG bulletin addresses what it means for an excluded individual or entity to violate an exclusion and the potential federal program consequences that can follow. It is relevant to compliance staff, coders, billers, auditors, and healthcare administrators who work with federal health care program participation rules and exclusion management. The article references applicable Social Security Act and federal regulations and frames the issue in terms of program integrity and reinstatement considerations.
Why This Topic Matters
Exclusion violations can create serious compliance and enforcement exposure for providers and organizations that bill federal health care programs. Understanding the bulletin helps readers recognize the federal authorities involved and the types of program integrity consequences discussed by OIG.
What You Will Learn
- How OIG exclusion issues are framed in a federal program integrity bulletin
- What categories of compliance consequences are associated with exclusion violations
- Which federal authorities are referenced in connection with exclusion and reinstatement issues
- Why exclusion status matters for organizations that interact with federal health care programs
Who Should Read This
- Compliance officers
- Medical coders
- Medical billers
- Revenue cycle staff
- Healthcare administrators
- Auditors
- Risk management personnel
Codes Discussed
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