OIG EXCLUSION LIST

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Hello everyone. I am from Alabama and voluntary surrendered my RN license and will be eligible to apply for reinstatement once I meet all of the requirements as requested by the board. Recently I received a letter in the mail from the office of inspector general stating that I am being considered to be placed on the OIG exclusion list which means I am able to work anywhere that takes Medicare or Medicaid. They said I had 30 days to reply. What should I include in the letter to try and get them to not place me on the list? Has anyone else experienced this? I need help! I have a family I have to provide for!

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I was placed on that list for 3years. I could not work anywhere that accepted Medicare, Medicad, VA benefits.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

OIG Exclusions Background Information page will help you understand this program.

MANAGING THROUGH AN EXCLUSION BY THE OIG

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OIG NOTICE REQUIREMENTS – KNOW THE LAW

If an individual and/or entity receives a Notice of Intent to Exclude from the OIG, keep in mind that according to the OIG, it does not necessarily mean they will be excluded. The OIG will carefully consider all information before making a decision. If a provider or entity receives an OIG Notice of Intent to Exclude or a Notice of Exclusion, seeking the advice of an attorney who has experience

This article may help you:

Responding to a "Notice of Intent to Exclude" from the Medicare Program

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You must act quickly when you receive the notice. The deadline for opposing exclusion is only 30 days. During that short time period, you must review the reasons for exclusion that are set forth in the notice, develop your arguments against exclusion, pull together all of the evidence in support of your arguments, and submit your opposition in a persuasive writing that will convince the OIG not to put you on the Medicare exclusion list.

How you respond will depend on whether you are subject to a "mandatory" or "permissive" exclusion....

 

It's in your best interest to hire an experienced Medicare exclusion lawyer to guide you through this process. 

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NRSKarenRN said:

OIG Exclusions Background Information page will help you understand this program.

MANAGING THROUGH AN EXCLUSION BY THE OIG

This article may help you:

Responding to a "Notice of Intent to Exclude" from the Medicare Program

It's in your best interest to hire an experienced Medicare exclusion lawyer to guide you through this process. 

If listed on OIG list can one still work at other insurance companies like Blue Cross etc?

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Specializes in Vents, Telemetry, Home Care, Home infusion.
Pink_Seashell said:

If listed on OIG list can one still work at other insurance companies like Blue Cross etc?

Since many Blue Cross ,Aetna, Humanna etc companies offers Medicare and Medicaid Managed Care plans, that is a decision each company would need to make.

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NRSKarenRN said:

Since many Blue Cross ,Aetna, Humanna etc companies offers Medicare and Medicaid Managed Care plans, that is a decision each company would need to make.

Thank you for your response.  I read the managing OIG exclusion list you posted, however it does not mention where a person can work if listed. My uncle is a NP in CA. He received notice he will placed on the exclusion list.  Any tips you can offer will be appreciated.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Private pay medical spa or IV hydration company might hire as not billing government entity.

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NRSKarenRN said:

Private pay medical spa or IV hydration company might hire as not billing government entity.

Hi NRSKaren

Would teaching nursing students be an option if RN/NP license are unaffected? 

Again Thank you so much for your time.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

If college/school/nursing students getting government funding, no.   Your uncle needs to check with nursing programs in his area.  Reason being placed on OIG list important too. I'm unable to provide further advice, Assuming he has a lawyer, follow their advice regarding future employment.

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NRSKarenRN said:

If college/school/nursing students getting government funding, no.   Your uncle needs to check with nursing programs in his area.  Reason being placed on OIG list important too. I'm unable to provide further advice, Assuming he has a lawyer, follow their advice regarding future employment.

Thank you so very much. 🙂

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Does anyone know if this is only for Medicaid, Medicare, or VA benefits. I have been contemplating a job in corrections because of state retirement so would OIG list exclusion make me ineligible for this type of position or is it mostly for medical facilities? Thanks

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trlg89 said:

Does anyone know if this is only for Medicaid, Medicare, or VA benefits. I have been contemplating a job in corrections because of state retirement so would OIG list exclusion make me ineligible for this type of position or is it mostly for medical facilities? Thanks

You could work in corrections as a corrections officer and be on the OIG exclusion list. You absolutely can't work as a Nurse in any jail or prison because the jail/prison gets funding from the government for the Healthcare of the inmates. You can't work for any facility related to Healthcare in any capacity if the facility gets just one penny per year in Federal Healthcare funding, so that means VA, Tricare, Medicaid, Medicare wgich is basically ANY and ALL Healthcare settings including dialysis, outpatient offices, even as a remote IT biller/coder, etc. The only exception would be in an aesthetician clinic or rural clinic that only accept cash for payment and these jobs are all locked up and none open. Most aesthetician clinics don't hire RNs anyway, but for the ones that do, these jobs never turn over and are highly desired and competitive.

But, if you chose to work in a prison as a corrections officer, that's fine. Remember, a surrendered or revoked nurse license is a permissible OIG exclusion and not a Mandatory exclusion. This means that after 5 years, you can get off of the OIG exclusion list. Mandatory exclusions such as Healthcare fraud carry for more than 5 years and sometimes 7 or 10, etc. 

This is why I tell nurses to never surrender their licenses. They have no idea of the consequences and my biggest reason for staying in nursing and doing the 5 year monitoring program wasn't because I wanted to stay in nursing. It was because the alternative to simply change careers would mean my license would immediately be revoked the day I quit monitoring, which then means I likely go on the OIG exclusion list.

 

 

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