The Complete Guide On OIG Exclusion List

Office of Inspector General (OIG) list is a list of excluded persons or entities that have abused or taken advantage of Medicare and other federal programs.

The Exclusion Database Check is done to check whether the name of a person exists on the OIG list.

What if your name is on the exclusion list?

If your name is available on the exclusion list, you will not get any payment for any item or service taken by you. The payment prohibition is valid to the following persons or entities:

-    Excluded person

-    Anyone who contracts with the prohibited person

-    Any healthcare entity for which the prohibited person provides services

If your name comes up in the Pennsylvania State Exclusion search, payment prohibition applies to you.

Are there any exemptions?

Yes, we have got some exemptions issued by the OIG to simplify the conditions where a healthcare provider may employ an excluded individual.

If the healthcare provider employs an excluded individual, he can do so. But he has to pay the individual exclusively with private funds and not from any federal sources.

How to get your name off the exclusion list?

If your exclusion period is over, you can request OIG (Office of Inspector General) to get your name off the list. The reinstatement process can take place only in the following conditions:

-    The exclusion period of that person is over

-    There will be no recurrence of the basis for the original exclusion for which your name came on the screen.

-    If there is any pending fine, you need to pay it to the healthcare provider.

Remember that the reinstatement process is not initiated automatically, but you have to begin the whole process to get your name off the list.

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