The OIG federal exclusion list is a database of individuals who have been convicted of crimes related to healthcare fraud and malpractice. In legal situations, this database may be referred to as LEIE, or the list of excluded individuals and entities. If your practice is listed in LEIE, you cannot receive any funds or benefits from US federal healthcare programs. Likewise, healthcare professionals on the exclusion list cannot receive funds from patients who rely on federal healthcare programs. This exclusion list can result in serious revenue problems for medical professionals.
Learning About Your Exclusion Status
If you are unsure about your status on the exclusion list, check the OIG’s Online Searchable Database. Regularly used by employers and healthcare professionals, this database will allow you to search for individuals who have been excluded from federal services due to criminal activities. If you receive a positive match in this database, take note of your term and reasons for exclusion. You should also begin checking with the OIG for updates.
While landing on the OIG’s list of excluded individuals can pose some serious problems for personal credibility and financial stability, it is not an irreversible situation. By examining the conditions and terms associated with your exclusion, you can create a strategy to remove yourself from the OIG federal exclusion list.
Beginning the OIG Reinstatement Process
Start your plan to be reinstated in federal healthcare programs by discovering the terms of your exclusion. The exclusion term is a duration when you cannot apply for or use federal healthcare services. During this exclusion term, you may not claim payments, and your name and status will be available in the database. Healthcare providers and employers are obligated to check patients’ and employees’ status with this information. This is required by sections 1128 and 1156 of the Social Security Act. Fortunately, you can begin the process to remove your information from the OIG list of excluded individuals when your term is over.
OIG reinstatement is a simple process, but you must submit the appropriate documents to the address that is available on your original exclusion notice. If you no longer have access to this information, you should contact the OIG office with a written request to receive a new exclusion letter. You should also consult the OIG website for updates about reinstatement procedures. After the OIG office receives your request, they will verify that your exclusion term has ended. They will also send you several authorization forms in the mail. These forms simply ask for your personal information, the details of your conviction, and your exclusion term.
The Importance of Timeliness
The OIG reinstatement process can be lengthy, so you should complete these forms as soon as possible. Most individuals who follow the reinstatement process can apply for federal healthcare services within 120 days of the form submission. Healthcare providers and the OIG office are required to wait until 90 days after your term has ended before they begin the reinstatement process; be prepared to submit the documents as soon as this waiting period is over. During this period, you should also check documents for accuracy. Errors can lengthen the reinstatement process to 12 months or longer.
Regaining Healthcare Benefits
When you have been removed from the OIG list of excluded individuals, you must reapply for the federal healthcare services that you need. The federal government does not have a system that automatically notifies healthcare providers of your removal from the OIG exclusion list. Furthermore, you may also need to check with your state’s databases to ensure that your removal from the exclusion list is complete.
Healthcare licensing boards may approve you for services by issuing you a provider number, but you may not use their services until your reinstatement is official. If you attempt to use healthcare services before the reinstatement process is over, the OIG database will flag you, and you will be declined. If you submit forms incorrectly or provide inaccurate documentation to the OIG office, your reinstatement may be canceled. This cancellation is not permanent, but you will need wait 365 days before you can restart the reinstatement process.
By learning the laws, gathering the appropriate documents, and creating a timeline to complete the reinstatement process, you can remove yourself from the exclusion list to regain access to federal healthcare services.