OIG Exclusion Database – Pharmacy Compliance

What is an OIG exclusion? 

The Office of Inspector General (OIG) has the authority to exclude individuals and entities from Federally funded health care programs for a variety of reasons. Those that are excluded can receive no payment from Federal healthcare programs for any items or services they furnish, order, or prescribe.

Don’t get caught violating a Federal Law because you were not informed of an excluded employee!

EXCLUSIONTrack takes the guesswork out of federal exclusion laws.

The government maintains lists of persons excluded from federally funded programs. Under revised Fraud, Waste, and Abuse rules, Pharmacies are required to check all employees against these lists monthly. EXCLUSIONTrack automatically performs monthly checks of employees, vendors and prescribers* against the General Services Administration (GSA) exclusion database and The Office of Inspector General (OIG) exclusion lists, ensuring you are meeting the practices required for Pharmacy Credentialing by PBMs and other entities.

The Office of Inspector General States

With regards to an OIG exclusion:

“An excluded person violates the exclusion if the person furnishes to Federal health care program beneficiaries items or services for which Federal health care program payment is sought. The law states that any excluded person that submits a claim or payment to a Federal health care program, or causes such a claim to be submitted, may be subject to a civil money penalty (CMP) of $10,000 for each claimed item or service furnished during the period that the person was excluded. And as a result of this exclusion violation, the person may also be subject to an assessment of up to three times the amount claimed for each item or service rendered. In addition, violation of an exclusion is grounds for OIG to deny reinstatement to Federal health care programs.”

Source: Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs; Issued May 8, 2013.

OIG exclusion screening is an important part of pharmacy compliance.  Our automated  ExclusionTrack program takes all of the guesswork out of OIG database screening and is included in all of our Compliance Programs!