The OIG’s Exclusion List – A Simple Check to Prevent Liability – Health Law Alert

Health Law Alert by Lamb McErlane PC attorneys Vasilios J. Kalogredis, Esq. and Sonal Parekh, Esq.
The Office of Inspector General (”OIG”) maintains a list of all currently excluded individuals and entities who are ineligible to participate in federal health care programs because of criminal activity (including Medicare or Medicaid fraud) or serious professional misconduct. The purpose of the List of Excluded Individuals/Entities (”LEIE”), also known as the OIG Exclusion List, is to (1) ensure that federal health care program beneficiaries have access to high quality providers; and (2) prevent any federal funds from flowing to individuals or entities who have demonstrated their disregard for the law and high standards of professional conduct. Exclusion is the most extreme civil sanction that can be imposed by the OIG and anyone who hires an individual or entity on the OIG Exclusion List may be subject to civil monetary penalties (”CMP”). Failure to check the LEIE may lead to missing updates and inadvertently retaining or hiring an excluded party, which exposes the health care entity to potential breach of contractual claims, CMP, and other administrative actions by state and/or federal authorities.
To avoid CMP liability and undoubtedly ensure continued contractual compliance, it is imperative that health care entities that receive federal health care program funds routinely check the OIG Exclusion List to ensure that potential new hires and current employees are not on it. It is important to note that the LEIE does not include historical exclusion data. The LEIE is updated monthly, and its current version, along with any updates thereto, can be found here.
The LEIE is one of two primary federal lists that should be checked for exclusion status by all entities that receive federal health care program funds. The other list that must be checked is SAM.gov. We highly recommend checking these lists monthly to help ensure against potentially major issues.
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Vasilios (“Bill”) J. Kalogredis is Chairman of Lamb McErlane’s Health Law Department. Bill has been exclusively practicing health law for over 45 years, representing physicians, dentists, group practices, other healthcare professionals and health care-related entities. bkalogredis@lambmcerlane.com; 610-701-4402.
Sonal Parekh is an associate in Lamb McErlane’s Health Law Department. Sonal’s practice is focused on healthcare transactional matters and a broad range of healthcare regulatory-related issues on behalf of healthcare systems and practices, physicians, dentists and other healthcare providers. sparekh@lambmcerlane.com; 610-701-4416.