Potentially Game-Changing OIG Exclusion Verdict

Potentially Game-Changing OIG Exclusion Verdict

Can a healthcare organization be entirely excluded simply by having an excluded individual amongst their staff roster?

We never would have thought so; but here comes another new wrinkle in the field of exclusion fines and punitive actions.

To quote the OIG report:

03-19-2015: Ambulatory Health Care Services, LTD. – a Skokie, Illinois home health agency was excluded from participation in all Federal health programs for a period of three years as a result of its employment of an excluded nurse. OIG’s investigation revealed that Ambulatory Health Care Services, LTD, billed the Federal health care programs for services provided by the excluded nurse to Medicare and Medicaid beneficiaries. The exclusion became effective March 19, 2015, and prohibits Ambulatory Health Care Services, LTD, from participating in the Federal health care programs. Ambulatory Health Care Services, LTD is no longer in operation.

Ambulatory-Health-Care-Services-skokie

We’ve heard of healthcare organizations receiving fines – sometimes hefty ones – as a result of unwittingly employing excluded individuals.  But to have the entire organization excluded entirely?  That’s a new one.

Some quick research reveals that Ambulatory, the excluded company, reportedly filed for Chapter 11 way back in 2012, as reported by Crain’s Chicago Business news. (News briefs: Skokie home-health company files for Chapter 11).  Did the OIG choose to take this unprecedented action simply because there were no assets to seize?  Or is this a new precedent of which we all need to be wary?

 

About Frank Strafford