Medicare Compliance & Reimbursement

If you happen to find yourself excluded, there are specific guidelines to follow to be reinstated under CMS. It is also important to remember that exclusion may affect other areas of your healthcare work and life.

Take a look at this quick go-to list for navigating an exclusion:

• The LEIE is only the OIG’s exclusion list. You may be blocked from other federal programs as well. The two other federal lists fall under the General Services Administration (GSA) and include restrictions from auxiliary federal programs. They are the Excluded Parties List System (EPLS) and the System for Award Management (SAM). Both can be accessed through the OIG website.
• Reinstatement requires a written and notarized request, and it must be sent to a specific address at the OIG. “Excluded providers may begin the process of reinstatement 90 days before the end of the period specified in the exclusion notice letter. Premature requests will not be considered,” the OIG’s FAQ states. “If reinstatement is denied, the excluded party is eligible to reapply after 1 year.”
• Though being on the excluded list may affect your chances for employment, it does not bar you from buying a house through the Department of Housing and Urban Development (HUD).
• Since your exclusion concerns the claims’ payment process of CMS, there is no need to worry about exclusion from receiving the benefits of Medicare and Medicaid as a beneficiary. Excluded entities are still eligible for coverage under CMS programs and other federal healthcare agencies.

For questions about exclusions, it is best to contact the OIG directly.Mail: HHS, OIG, OI, Attn: Exclusions, P.O. Box 23871, Washington, DC 20026Phone: (202) 691-2311 Fax: (202) 691-2298 Email: sanction@oig.hhs.gov.