CodeMap Compliance Briefing: 8/20/04
Exclusions are one of the most effective tools used by Congress and the federal government to protect Medicare and other federally funded health care programs from fraud and abuse. In certain situations, the Office of Inspector General (OIG) has the power to exclude individuals and entities from participation in the federally funded health care programs. Exclusion from these programs means that no payment will be made by any federal health care program for goods and/or services ordered, prescribed, furnished, or performed by an excluded individual. In addition, no payment will be made to any entity that employs and/or contracts with an excluded individual. Considering the significant percentage of patients covered by federal health care programs, such as Medicare and Medicaid, exclusion is a serious blow to any practice or provider organization. This week we will examine the OIG's exclusion program and what steps your provider organiza....
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