Healthcare Providers Fined for Failing to Check the HHS-OIG Exclusions List
Two healthcare providers who employed individuals who had been excluded from participation in Federal healthcare programs have entered into settlement agreements with the Department of Health and Human Services Office of Inspector General (HHS-OIG).
HHS-OIG is required by law to maintain an exclusions list of individuals who have been convicted of Medicaid/Medicaid fraud, SCHIP, state healthcare programs, patient abuse and neglect, felony convictions for other healthcare-related fraud, financial misconduct, theft, and unlawful manufacture, distribution, prescription, or dispensing of controlled substances. HHS-OIG also has the discretion to exclude individuals from Federal healthcare programs on other grounds, including a range of healthcare-related misdemeanor convictions, false claims submissions, and unlawful kickback arrangements. Healthcare organizations must routinely check the HHS-OIG List of Excluded Individuals/Entities (LEIE) to check that current employees and new hires have not been added to the LEIE. If a healthcare organization employs an excluded individual, they will be subject to civil monetary penalties.
In late September, Patient First New Jersey Physicians Group agreed to settle allegations that a lab technician and supervisor on the HHS-OIG exclusions list provided items or services that were billed to Federal health care programs. HHS-OIG settled the alleged violation for $25,809.81. In October, Chattanooga, TN-based RC Ventures, Inc., which does business as BrightStar Care of Chattanooga, agreed to a $20,374.43 settlement with HHS-OIG after employing a caregiver and billing items or services to Federal health care programs when that individual had been excluded from participation in Federal health care programs.
The penalties for employing excluded individuals can be severe. In June, The Estates of St. Louis in Missouri agreed to a $300,000 settlement for employing an excluded charge nurse and billing services to Federal health care programs, and in February Baptist Health System in Kentucky settled similar allegations with HHS-OIG for $184,000.
HHS OIG Exclusions List
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