States regularly fail to notify the HHS Office of Inspector General
when they have expelled health care providers from their Medicaid
programs for incompetence, fraud and other reasons that would prohibit
them from receiving federal reimbursements, according to federal
investigators, the AP/San Francisco Chronicle reports.
The lack of notice keeps the providers off OIG's reimbursement
exclusion list, making it easier for barred providers to work in other
areas of the country and continue to receive federal funds, according
to the report.
Federal investigators surveyed states to
determine how often Medicaid programs sanction a provider in a way that
would place them in OIG's exclusion database. Reasons for exclusion
include fraud convictions, patient abuse, licensing board sanctions and
default on federal education health loans. No federal payments can be
made for any services that an excluded provider performs, orders or
prescribes, according to federal law. Forty-seven states responded to
the survey.
when they have expelled health care providers from their Medicaid
programs for incompetence, fraud and other reasons that would prohibit
them from receiving federal reimbursements, according to federal
investigators, the AP/San Francisco Chronicle reports.
The lack of notice keeps the providers off OIG's reimbursement
exclusion list, making it easier for barred providers to work in other
areas of the country and continue to receive federal funds, according
to the report.
Federal investigators surveyed states to
determine how often Medicaid programs sanction a provider in a way that
would place them in OIG's exclusion database. Reasons for exclusion
include fraud convictions, patient abuse, licensing board sanctions and
default on federal education health loans. No federal payments can be
made for any services that an excluded provider performs, orders or
prescribes, according to federal law. Forty-seven states responded to
the survey.
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