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OIG Special Advisory Bulletin on Exclusion from Participation in Federal Health Care Programs

The OIG announced this week that it released an updated “Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs.” This is the first update that has been made since 1999. Since the original bulletin was published, federal programs and statutes have been adopted and strengthened that have given the OIG more authority to oversee which individuals should be excluded, which has created more questions from providers.

According to the bulletin, it is prohibited to have a Federal health care program payment made to excluded individuals, even those who are not providing direct care. For instance, nursing home services will not be paid for if the services have been provided by these individuals, including those in administration or management. It provides information on how to determine whether a person is excluded as well as on the self-reporting process if it is required.

To view the bulletin, click here.

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