Excluded Providers

News & Analysis as of

To Terminate or Not to Terminate: Provider Exclusion Laws and Why They Matter

A robust, quality network of providers is essential to the operation of any managed care organization (MCO). Credentialing, quality of care, or other legitimate business concerns frequently require an MCO to evaluate removal...more

Updated OIG Exclusion Guidance Spells Out Recommended Employee Screening Procedures

On May 8, 2013, the Office of Inspector General (OIG) published an updated bulletin that spells out the frequency with which employers should check the OIG’s List of Excluded Individuals and Entities and clarifies which...more

Fourteen Years Later: New OIG Guidance On Excluded Providers

In This Issue: - Exclusion from Federal Health Care Programs - The New Advisory Bulletin - What Providers Should Know - For More Information - Excerpt from Exclusion from Federal Health Care...more

Do Not Pay: The Government’s Newest Tool

In previous posts and presentations, I have emphasized the critical role that data prospecting will play in the government’s efforts to prevent health care fraud, waste and abuse. Here’s further support for the proposition....more

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