Exclusion from participation in medicare and medicaid: some selected features and distinctions from state and federal law

Abstract

The sanction of exclusion of a practitioner from participation in government funded healthcare programs because of his own health program offenses has existed since 1977 under federal laws and 1997 under state statutes. Now, severe Civil Monetary Penalties can be assessed in addition to exclusion; and, practitioners can be severely fined, as well as themselves excluded, if they hire someone excluded while at other employment, if that new employee's services are reimbursed, directly or indirectly, by a federal health care program even if that excluded employee does not furnish direct patient care to the government program beneficiary.