Health care law encompasses a wide range of issues. Learn more about regulations, legislation and general information involving health care providers and professionals (physicians, nurses, pharmacists, therapists, mental health counselors, rehab facilities, nursing homes, DME suppliers, medical students and interns, pain management clinics, hospital administrators, etc.) including information regarding the Department of Health, professional boards (Board of Nursing, Board of Pharmacy, Board of Dentistry, Board of Medicine, etc.), DEA, AHCA (Florida Agency for Health Care Administration) and Medicare and Medicaid.
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Have you ever had disciplinary action against your license as a health care professional? Have you ever been arrested or convicted of a criminal offense? Have you ever been convicted of fraud or patient neglect? If so, then you may have also been terminated or excluded from the federal Medicare Program or your state Medicaid Program.
Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their career and employment. Whether you are a physician, nurse, dentist, psychologist or other health professional, if you allow yourself to be excluded from the Medicare Program, devastating economic results may follow.
Check the List.
To check if you are on the federal government’s List of Excluded Individuals and Entities (LEIE), click here.
To see if you are on Florida’s list of individuals and entities who have been terminated from Florida’s Medicaid Program, click here.
Collateral Consequences to OIG Exclusion or Termination.
Termination or exclusion can have many collateral consequences about which most health care providers are not aware. These Include:
– Termination for cause from all state Medicaid Programs.
– Loss of state professional licenses in other states and jurisdictions.
– Loss of hospital, ambulatory surgical center (ASC), and nursing home clinical privileges.
– Removal from the provider panels of health insurers.
– Loss of ability to contract or work for any individual or entity that contracts with the Medicare Program in any capacity (officer agent, shareholder, director, employee or independent contractor, even for non-Medicare products and services such as office supplies, building and construction services, software and systems support, etc.), including physicians, medical groups, hospitals, healthcare systems, ambulatory surgical centers, skilled nursing facilities, health insurance companies, etc.
– Placement on the General Services Administration (GSA) Exclusions List (or “Debarred” List) from government contracting.
– Loss of ability to contract or work for any individual or entity that contracts with the federal government in any capacity (officer agent, shareholder, director, employee or independent contractor, even for such services as construction projects, janitorial contracts, computer equipment and software services, real estate brokers on federally underwritten housing loans, sales of motor vehicles, products and services to the government, etc.
To learn more on the consequences of being excluded, click here.
You’re on the List, Now What?
If you find yourself on a state’s excluded or terminated list or if you find yourself on the federal LEIE, all is not lost. There are ways to become reinstated.
The OIG exclusion list is a complicated regulatory program which requires experience and perseverance to navigate. It is highly recommended that you do not attempt to handle removal without qualified assistance. If your application is denied, even for hyper-technical reasons, you may be barred from reapplying for one full calendar year. Therefore, it is crucial that your application is complete and correct, and you are fully eligible for removal. To read a past blog about reinstatement after OIG removal, click here.
Contact Attorney Experienced in Defending Against Action to Exclude an Individual or Business from the Medicare Program and Assisting in Reinstatement Applications.
The attorneys of The Health Law Firm have experience in dealing with the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS), and defending against action to exclude an individual or business entity from the Medicare Program, in administrative hearings on this type of action, in submitting applications requesting reinstatement to the Medicare Program after exclusion, and removal from the List of Excluded Individuals and Entities (LEIE).
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
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