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  1. #1
    Join Date
    Nov 2015
    Posts
    2

    Default Reinstating a Nursing License With an Error in the OIG Exclusions List

    I am soon going to be completing requirements for an RN license reinstatement. My question is regarding information that is on the OIG Exclusions List that is incorrect. This information was, in turn, reported to the National Practitioner Databank.

    In 2003, I was convicted of Felony Theft. The agency involved was the Indiana Medicaid Fraud Unit. They also reported to the National Practitioner Databank.

    Also in 2003, the Office of the Inspector General placed me on the Exclusions list but for Healthcare Fraud. I was not and have never been convicted for Healthcare Fraud. My RN license was suspended but that was not what the OIG placed me on the Exclusions List for.

    I need to know how to A) Get the OIG to remove the incorrect information, B) Remove me from the Exclusions List, as it has been more than 5 years, and C) Report the corrected information and the fact that the conviction for Theft was Expunged in 2014 to the National Practitioner Databank.

  2. #2
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: Reinstating a Nursing License With an Error in the OIG Exclusions List

    You were notified of an administrative action against you, that would result in your being added to the OIG's exclusion list. You either chose not to contest the exclusion, such that the proposed action was carried out as described, or you disputed the exclusion and were unsuccessful in your effort. Which path did you choose?

  3. #3
    Join Date
    Nov 2015
    Posts
    2

    Default Re: Reinstating a Nursing License With an Error in the OIG Exclusions List

    I did not dispute the action because I did not realize that I could dispute anything either on the NPDB or with the OIG for one, and secondly I didn't see the entry for Healthcare Fraud until recently.

  4. #4
    Join Date
    Sep 2005
    Location
    Behind a Desk
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    98,846

    Default Re: Reinstating a Nursing License With an Error in the OIG Exclusions List

    Read this.
    Quote Quoting What is OIG's Administrative Process for Imposing Exclusions
    For all proposed mandatory exclusions (1128(a)(1)-(4) of the Act) that are longer than the mandatory minimum five-year period, and most proposed permissive exclusions (1128(b)(1)-(b)(5), (b)(8)-(b)(11), and (b)(14)-(b)(15), and (b)(16) of the Act), the administrative process is the same. OIG sends out a written Notice of Intent to Exclude to any individual that we are considering excluding. The Notice of Intent to Exclude includes the basis for the proposed exclusion and a statement about the potential effect of an exclusion....

    When OIG is considering excluding an individual or entity under 1128(b)(7) of the Act, the administrative process differs from those described above. OIG will send the individual or entity a Notice of Intent to Exclude, after which the individual or entity has 30 days in which to respond in writing as described above. If OIG decides to proceed with exclusion, we send the individual or entity a Notice of Proposal to Exclude. The written notice will include the basis for the proposed exclusion, the length of the exclusion, the factors we considered in setting the exclusion period, the effect of the exclusion, appeal rights and reinstatement information. The individual or entity may file a written request for a hearing within 60 days of receipt of the Notice of Proposal to Exclude. If the individual or entity does not request a hearing, OIG will send a Notice of Exclusion 60 days after the individual or entity's receipt of the Notice of Proposal to Exclude. The exclusion goes into effect 20 days after the date of the Notice of Exclusion. If the individual or entity makes a timely request for a hearing, an exclusion will not go into effect until and unless the ALJ upholds the OIG's decision to exclude. Any adverse decision may be appealed to the DAB, and judicial review is available after a final decision by the DAB.
    Review the notice you received. Did they follow proper procedure and provide the described notice?

  5. #5
    Join Date
    Sep 2011
    Location
    OH10
    Posts
    17,019

    Default Re: Reinstating a Nursing License With an Error in the OIG Exclusions List

    It sounds like the Board of License decided your felony was going to disqualify you and did not care to accept your explanation as excusable. Not surprising with a felony.

    "What happens if you find a criminal record?
    The board has the discretion to either approve your application without any further action or request your appearance in front of the board to discuss the matter further. If a personal appearance is requested, the board may request supplemental information from you including an explanation of the criminal event(s) and disposition documentation."

  6. #6
    Join Date
    Sep 2010
    Posts
    19,901

    Default Re: Reinstating a Nursing License With an Error in the OIG Exclusions List

    I'm not sure I understand how felony theft from medicare isn't healthcare fraud generically.

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