New Direction on OIG Program Exclusions

Thomas Herrmann | March 2017

New Guidance Will Help Health Care Entities and Practitioners

Facing Potential Legal Exposure.

The Office of Inspector General (OIG) in the U.S. Department of Health and Human Services (HHS) has issued new guidance on the process it will follow to determine whether a health care organization or practitioner should be excluded from participation in federal health care programs (e.g., Medicare and Medicaid). The guidance issued in April 2016 supersedes a similar transmittal that the OIG issued in 1997.


By way of background, the OIG has the authority to exclude entities and individuals from participation in federal health care programs. The OIG advises that:

Exclusion is a remedial measure designed to protect the Federal health care programs from any person who continued participation in the programs constitutes a risk to the programs and…

About the Author

Thomas Herrmann advises health care clients on compliance and regulatory matters, with a focus on development and management of effective health care compliance programs. Mr. Herrmann is a recognized expert on issues related to the federal Anti-Kickback Statute, Stark Law and the False Claims Act.