Wednesday, June 4, 2014

OIG Proposes Rule to Expand Exclusion Authorities

Dianne De La Mare

In May, the US Department of Health and Human Resources, Office of Inspector General (OIG) published a proposed rule, Fraud and Abuse: Revisions to the Office of Inspector General’s Exclusion Authorities that would significantly expand the exclusion regulations applicable to persons or entities that receive, directly or indirectly, funds from federal health care programs (including Medicare and Medicaid programs).

The Affordable Care Act (ACA) expanded OIG’s authority for exclusion and authorized the use of testimonial subpoenas in investigations of exclusion cases. In the proposed rule, OIG incorporates these statutory changes, revises the definitions applicable to exclusions, proposes early reinstatement procedures and offers a number of proposed policy changes as to when and how exclusions take place.

AHCA/NCAL will submit formal comments by the July 8th deadline in response to OIG’s proposed rule, and asks that you submit any feedback or comment by Monday, June 30th directly to Dianne De La Mare at

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