BC Advantage - 2013 Issue 8

OIG UPDATES ADVICE ON DEALING WITH EXCLUDED PROVIDERS

By: William J. McDonald, Esq. Medical practices must remain vigilant in their compliance efforts to root out and avoid excluded providers.  The Office of the Inspector General for Health and Human Services ("OIG") remains aggressive in its enforcement efforts, and providers who present claims for payment to Federal health care programs for services provided by excluded providers face liability under the Civil Monetary Penalties Law, codified at 42 U.S.C. §1320(a)-7(a).  Civil Monetary Penalties ("CMPs") include a $10,000 fine for each individual violation, plus potential liability for three times the amount of reimbursement claimed...

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