EDUCATION: What is the difference between CMS Preclusiona and OIG Exclusion

18/06/2025 5 min Temporada 5 Episodio 7

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Episode Synopsis

Web: www.JonesHealthLaw.comPhone: (305)877-5054Instagram: @JonesHealthLawFacebook: @JonesHealthLawYouTube: @JonesHealthLawThe Centers for Medicare & Medicaid Services (CMS) established the Preclusion List under its authority to administer Medicare Advantage (MA) and Part D programs. The list features healthcare providers and prescribers who are precluded from receiving payment for items or services furnished to Medicare beneficiaries enrolled in MA plans or for prescriptions covered under Part D.The U.S. Department of Health and Human Services, Office of Inspector General (OIG) maintains the List of Excluded Individuals and Entities (LEIE) under the authority of the Social Security Act §§ 1128 and 1156. Exclusions are imposed on individuals or entities found to have engaged in certain misconduct, such as fraud or patient abuse.

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