Employing an excluded individualConsequences to Employing an Excluded Individual
How much are healthcare providers and business typically fined?
Such companies are normally fined between USD 30,000 to USD 300,000. There have been multiple cases however where CMPs have amounted to millions of dollars in fines.
Can an OIG fine be reversed if the employer was unaware of the excluded status of an excluded employee?
No, it may not. Businesses must screen its employees not only against the OIG Exclusions database. It must also do this against all possible federal and state exclusions databases on a monthly basis. Ignorance or unintentional lapses is not an excuse.
May healthcare providers and businesses employing or contracting with those under OIG Exclusion seek reimbursement for services rendered or items given?
No, healthcare providers and business may not seek reimbursement for goods or services connected with those under the LEIE. Such companies potentially face stiff Civil Monetary Penalties (CMP) at a minimum of USD 10,000 per violation. The penalty is for each item or service submitted for reimbursement.
Can an employer be sued for mistakenly firing an employee thought to be an excluded individual?
Yes, an employer may be sued. Identical names commonly appear during the exclusions search screening process. It is the responsibility of an employer however to further verify that an employee or potential hire is in fact, excluded.
What are some of the ways to further verify if an individual is the same person appearing on the OIG Exclusions list?
The OIG Online Searchable Database will ask for the first and last name of the individual. Searchers can further establish the individual’s identity by matching the individual’s:
● Date of birth
● Date of birth
● Social Security Number