New bill would expand the scope of who can be excluded due to healthcare fraud

US House of representatives Lois Frankel (D-Fla.) and William Keating (D-Mass.) introduced a bill to amend title XI of the SSA to expand fraud fighting efforts on May 18th. The bill would let the OIG (Office of the Inspector General) exclude individuals from healthcare programs if they are affiliated with an organization that has been penalized for certain types of medical fraud. This means that executives of a company found to be engaging in fraudulent activity cannot avoid exclusion from future participation in Medicare or Medicaid programs by resigning prior to penalization of the company. This bill is one step closer towards the OIGs recommendations to take a stronger stance on pursuing healthcare fraud.

“To amend title XI of the Social Security Act to expand the permissive exclusion from Federal health programs to include certain individuals with prior interest in sanctioned entities and entities affiliated with sanctioned entities and to provide a criminal penalty for the illegal distribution of Medicare, Medicaid, or CHIP beneficiary identification or provider numbers, and for other purposes.”

Want to learn more?

Memorandum – Individual Accountability for Corporate Wrongdoing

Lawmakers Propose Expanding OIGs health Program Exclusion Authority

Why healthcare executives should take note of the DOJ’s recent Memo

#CMS #healthcarefraud #OIG