Proposed Rule Would Ramp Up HHS Power to Ban Providers From Federal Healthcare Programs

The HHS Office of Inspector General has released a proposed rule that would increase the agency's authority to exclude individuals and entities from federal healthcare programs.

The Patient Protection and Affordable Care Act significantly expanded the OIG's authority to protect federal healthcare programs from fraud and abuse. In order to codify the changes made by the PPACA, the OIG has proposed changing regulations to allow for exclusions imposed in the following circumstances:

  • Conviction of an offense in connection with obstruction of an audit
  • Failure to supply payment information to Medicare or a state healthcare program
  • Making or causing to be made any false statement, omission or representation of fact in applications to participate in a federal healthcare program

The rule would also let the OIG issue subpoenas in investigations of exclusion cases. For more information, view the full text of the rule here.

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