Texas Mental Health Provider Settles Case Involving Excluded Individual

On October 17, 2017, MHMR of Tarrant County (MHMR), Fort Worth, Texas, entered into a $97,869.78 settlement agreement with OIG. The settlement agreement resolves allegations that MHMR employed an individual who was excluded from participation in any Federal health care programs. OIG’s investigation revealed that the excluded individual, a program director, provided items or services…

What To Know About New HHS OIG Exclusion Regs

Expert Analysis By Judith Waltz and Jill Wright, Foley & Lardner LLPJanuary 30, 2017, 12:34 PM EST Law360, New York (January 30, 2017, 12:34 PM EST) — On Jan. 12, 2017, the Office of Inspector General of the U.S. Department of Health and Human Services issued the third and final installment of its recent three-part rulemaking effort — a final rule…

Why conduct Exclusion monitoring?

Here are a few reasons to conduct exclusion monitoring. 1. Healthcare organizations cannot employ an excluded individual or entity if participating in any Federal healthcare program, to do so will result in fines. 2. Several State Medicaid Agencies have their own state exclusion list. 3. Several State Medicaid Regulations require monthly exclusion monitoring. 4. Per…

New York Physician Agrees to 5 Year Exclusion

12-09-2016 New York Physician Agrees to 5 Year Exclusion On December 9, 2016, Dr. Michael Esposito agreed to be excluded from participation in all Federal health care programs for a period of five years under 42 U.S.C. § 1320a-7(b)(7). OIG’s investigation revealed that Dr. Esposito forged the signature of another physician on prescriptions for medications…

Detroit-Area Home Health Care Agency Owner Sentenced to 30 Years in Prison for $33 Million Medicare Fraud Scheme

The owner of several Detroit home health care companies was sentenced today to 360 months in prison for his role in a Medicare fraud scheme that caused approximately $33 million in losses. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan,…

New Jersey OB/GYN Settles Fraudulent Billing Allegations, Agrees to 20-Year Exclusion from Medicare, Medicaid

November 15, 2016 A New Jersey OB/GYN, Labib Riachi, agreed to be excluded from participation in Federal health care programs, including Medicare and Medicaid, for 20 years to settle allegations by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), that Dr. Riachi submitted thousands of claims for Pelvic Floor Therapy…

Avoid the unknown & get checked!

Avoid the unknown & get monthly checks for Exclusion. It is better to be safe then sorry! Applying for Reinstatement: Reinstatement of excluded entities and individuals is not automatic once the specified period of exclusion ends. Those wishing to again participate in the Medicare, Medicaid and all Federal health care programs must apply for reinstatement…