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Nurse Defense and the OIG Exclusion List
If you are seeking employment as a nurse, your potential employer is required to check the website of the OIG, or Office of Inspector General, to see if your name is on their exclusion list. If you are found on the OIG sanction list, you will have a hard time getting hired.
Ability to Work as a Nurse while on OIG Exclusion List
It basically works like this: all healthcare employers are required to check the OIG website before hiring a potential nurse. If the nurse has had their professional license suspended or revoked or has a conviction for Medicare fraud, drug diversion, drug sales or patient abuse, they can be put on the OIG exclusion list. This means that the nurse is “excluded” from providing any federal healthcare. Medical facilities that receive federal funding for health programs such as Medicare or Medicaid cannot have a nurse who is on the OIG list provide care. Since most hospitals and clinics do receive some kind of federal healthcare funding, nurses on the OIG exclusion list are essentially unemployable.
Therefore, it is vital to avoid getting on the OIG list. The important thing to remember here is that if you think you might have problems with the nursing board in your state, make sure to hire an experienced nurse attorney right away to help defend yourself. If you end up becoming sanctioned by the state board of nursing, it is possible you could also end up on the federal OIG list.
What a Nurse Can Do
The OIG will send a letter first advising you that they are considering putting you on the exclusion list. You will then have 30 days to write a letter explaining any mitigating circumstances and hopefully persuade them not to put you on the list. A nursing attorney can help you with this process.
Exclusions are either permissive or mandatory. The OIG has the discretion to exclude or not exclude a nurse with certain kinds of misconduct including misdemeanor drug convictions and license suspension or revocation by the state board of nursing. For more serious misconduct, such as Medicare fraud or a felony drug conviction, the exclusion is mandatory.
If you do end up on this list, you have the right to appeal. The exclusion period will be for a certain amount of time – for example, five years – and once that time has passed, you can apply to have your name removed from the exclusion list. It is important to note that you will not be automatically taken off the exclusion list once the exclusion period is up – you need to apply for reinstatement.
It is certainly better to be proactive and fight to resolve allegations from your state’s board of nursing before the OIG becomes involved. However, if you are contacted by the OIG about a possible exclusion, there are still actions that can be taken. If you are a nurse in Louisiana and Mississippi and need help defending yourself against the BON or the OIG, please call my office for a free consultation.