On May 8, 2013, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) published an updated Special Advisory Bulletin (SAB) on the scope and effect of federal healthcare program exclusion. OIG is the agency with the authority to exclude from participation in Medicare, Medicaid, and other federal healthcare programs individuals and entities who have engaged in misconduct related to federal healthcare programs. The SAB updates and narrows guidance OIG issued 13 years ago on the practical implications of exclusion. Notably, the new guidance, in apparent conflict with current regulations, asserts that exclusion is limited to federal healthcare programs and does not prohibit excluded individuals and entities from participating in other government programs, including procurement programs. At the same time, however, the SAB details the significant effort the OIG expects of the industry to monitor arrangements and thereby avoid potential Civil Monetary Penalties (CMPs) for violating the exclusion provisions.
Additional information regarding the SAB can be found in a Hogan Lovells Health Alert.