In the literal sense, the OIG Exclusion’s List is a list of businesses and individuals who have violated federally funded health care programs.“ For many years the Congress of the United States has worked diligently to protect the health and welfare of the nation's elderly and poor by implementing legislation to prevent certain individuals and businesses from participating in Federally-funded health care programs….Bases for exclusion include convictions for program-related fraud and patient abuse, licensing board actions and default on Health Education Assistance Loans.” (Office of Inspector General Exclusions Program).
However, due to government programs it protects, a large amount of the list consists of pharmacies, pharmacists, pharmacy techs and nurses.
In essence, this simply means that no Federal Government program, including Medicare and Medicaid will pay for … “any items or services furnished, ordered, or prescribed by an excluded individual or entity.” (Office of Inspector General Exclusions Program). This is not just idle chatter by the OIG, they mean business and issue very heavy fines and stiff monetary penalties for hiring anyone on the list. In addition to the OIG, Social Security can also come down on any pharmacy or business that practices in fraudulent business actions or hires an employee whose name is on the list. A pharmacy owner in Georgia was fined $400,000 by Social Security after hiring a pharmacist who was on the OIG list. The fine was the total cost of all the medications the hired pharmacist had helped to dispense plus the dispensing fee. And that was just Social Security fines. “If this was the action by OIG, the federal agency could have also imposed an additional $10,000 fine for each medication dispensed by the excluded pharmacist.” (OIG exclusions list: Sounding alarm for awareness”, Pharmacy Today, 10/08).
Of course, there is always the flip side of the coin to argue - those who are mistakenly put on the list and those cleared of any wrongdoing but whose names remain on the list. In these cases, a great deal of time and money are spent trying to get your name cleared and off the OIG list, not to mention the money spent on an education in a career you can no longer practice. In the end, there is no doubt the list was put into effect to provide a safe harbor for the elderly and the poor who have little resources to check those in charge of prescribing and dispensing their medications. Just another way that Uncle Sam watches out for his citizens. But you can also check to see if the health care provider you use is on the list. Just log on to the OIG website and follow the instructions.
However, due to government programs it protects, a large amount of the list consists of pharmacies, pharmacists, pharmacy techs and nurses.
In essence, this simply means that no Federal Government program, including Medicare and Medicaid will pay for … “any items or services furnished, ordered, or prescribed by an excluded individual or entity.” (Office of Inspector General Exclusions Program). This is not just idle chatter by the OIG, they mean business and issue very heavy fines and stiff monetary penalties for hiring anyone on the list. In addition to the OIG, Social Security can also come down on any pharmacy or business that practices in fraudulent business actions or hires an employee whose name is on the list. A pharmacy owner in Georgia was fined $400,000 by Social Security after hiring a pharmacist who was on the OIG list. The fine was the total cost of all the medications the hired pharmacist had helped to dispense plus the dispensing fee. And that was just Social Security fines. “If this was the action by OIG, the federal agency could have also imposed an additional $10,000 fine for each medication dispensed by the excluded pharmacist.” (OIG exclusions list: Sounding alarm for awareness”, Pharmacy Today, 10/08).
Of course, there is always the flip side of the coin to argue - those who are mistakenly put on the list and those cleared of any wrongdoing but whose names remain on the list. In these cases, a great deal of time and money are spent trying to get your name cleared and off the OIG list, not to mention the money spent on an education in a career you can no longer practice. In the end, there is no doubt the list was put into effect to provide a safe harbor for the elderly and the poor who have little resources to check those in charge of prescribing and dispensing their medications. Just another way that Uncle Sam watches out for his citizens. But you can also check to see if the health care provider you use is on the list. Just log on to the OIG website and follow the instructions.
In addition to being required to check the OIG list, Pharmaceutical Strategies has the resources to stringently check pharmacists and allied health professionals for licensing discrepancies so our clients never have to worry about the professional health of our candidates.
Please contact us at www.pharmaceuticalstrategies.com
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