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Excluded Individual, but….a waiver

Excluded Individual, but….a waiver

Did you know . . .

that there are very limited circumstances in which a person who is excluded by the OIG can still provide services without incurring a penalty?  It’s true.  But in a very limited cases.  As the OIG reported recently,  a provider in a rural area, where there are no other options or access to such medical service, can still provide services and be reimbursed by federal health care dollars, IF he/she obtains a waiver from the OIG.

The OIG Waiver program is outlined on their site.  Essentially, The OIG can issue a waiver only for excluded providers who are the sole community physician or the offer essential specialized services in a community. Waivers cannot be granted to those excluded for patient neglect or abuse. See section 1128(a)(2) of the Act.

A waiver may be requested only by the administrator of a Federal or State health program. Excluded individuals or entities may not request a waiver from the OIG. For more information on waivers.

To date, the OIG has only granted a total of 23 waivers to individuals and/or clinics.

So in this case, an exclusion is waived.

Written by Michael Rosen, ESQ
ProviderTrust Co-Founder, mrosen@providertrust.com

Michael brings over 20 years of experience founding and leading risk mitigation businesses, receiving numerous accolades such as: Inc Magazine’s Inc 500 Award and Nashville Chamber of Commerce Small Business of the Year
Connect with Michael on Linkedin

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