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Sobering developments on federal healthcare program exclusion

21 December 2010

Health Alert

The scope and use of the federal healthcare program exclusion authority continues to evolve. Over the past few weeks, a federal district court upheld the exclusion of three former pharmaceutical industry executives based on their responsible corporate officer doctrine convictions. The Department of Health and Human Services Office of the Inspector General (OIG) announced another unprecedented exclusion, this time against a former pharmaceutical company shareholder. Congress repealed a mandate that state Medicaid programs exclude a wide swath of individuals and entities based on affiliations with federally sanctioned entities, which had already had the effect of complicating settlements of healthcare fraud cases. These developments present a sobering picture for individuals working in the healthcare industry and emphasize the importance of responding to the OIG's request for comment on its guidance on the effect of federal health program exclusion.



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