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Services
| Medicare and Medicaid OIG Sanctions The United States Department of Health & Human Services, Office of Inspector General, excludes certain individuals and entities from participation in Medicare, Medicaid, and other Federal health care programs. The OIG imposes exclusions on over 15,000 individuals and entities based upon the authority contained in Sections 1128 and 1156 of the Social Security Act The affect of the exclusion is that no program payment can be made for any items or services, including administrative and management services, furnished, ordered or prescribed by an excluded individual or entity under the Medicare (title XVII), Medicaid (title XIX), Maternal and Child Health Services Block Grant (title V), Block Grants to States of Social Services (title XX) and State Children’s Health Insurance (title XXI) programs during the period of exclusions. Program payment can not be made to any entity in which an excluded individual is serving as an employee, administrator, operator, or in any other capacity, for any services on or after the effective date of this exclusion. No payment can be made to any business or facility, e.g., a hospital, that submits bills for payment for items or services provided by an excluded party. Section 1128 exclusion actions with a sanction effective date after August 5, 1997 are also excluded from all Federal health care programs. The Sanction database is updated monthly from data provided by the OIG and contains 18 sanction types, comprised of over 50 categories. Key Benefits
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