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Case Detail


In re: HHS Revision of Exclusion Criteria
On September 10, 2014, WLF filed formal comments with HHS’s Office of the Inspector General (OIG), urging OIG to revise its existing criteria governing when it will use its authority to exclude entities and individuals from participation in federal health care programs. WLF noted that the relevant exclusion statute, § 1128(b)(7) of the Social Security Act, permits, but never requires, exclusion for a variety of statutory offenses (such as violations of the False Claims Act or the anti-kickback statute). WLF urged OIG to make clear that exclusion will never even be on the table as a potential sanction when a corporate compliance program is in place and the entity has been acting in good faith to implement the program. WLF argued that under those circumstances, the existence of isolated statutory violations provides no basis for concluding that an entity cannot be trusted to comply with federal law in the future, and that untrustworthiness is the only permissible basis for exclusion.
Case Status:
Awaiting agency response.
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