As a participating provider with Medicare and/or Medicaid, payments made by you to any vendor who is currently excluded from participation in Medicare and Medicaid is prohibited. This prohibition against payment applies if the entity or any individual with over 5% ownership is currently excluded.
Failure to screen vendors creates a risk to providers of hefty fines, monetary penalties and possible exclusion from participating in Medicare and Medicaid. This risk is based upon the OIG’s assertion that healthcare providers “know or should have known” that payments are prohibited to excluded vendors. Any provider that fails to screen vendors is liable if any payments are made to excluded individuals or entities.