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“A Look At OIG’s Medicare Exclusion Analysis Under FCA”

Law360 David Blank

Below is an excerpt:

On Aug. 17, 2018, a U.S. Department of Health and Human Services administrative law judge issued a decision upholding the Office of Inspector General’s exclusion of a laboratory and its CEO under Section 1128(b)(7) of the Social Security Act for a period of 15 years. The exclusion was based on the laboratory’s submission of false claims for mileage reimbursement that did not satisfy Medicare’s payment requirements. The decision is notable as it’s the first ALJ permissive exclusion decision under Section 1128(b)(7) of the act since 2011.