What is an exclusion?

An exclusion is defined as administrative action taken by the Office of Inspector General (OIG) and/or State Medicaid Agency to exclude an individual or entity within the healthcare realm based on a criminal conviction(s) and/or a license revocation. The effect of an exclusion is that the person or entity cannot participate in or have federal healthcare dollars reimbursed to their employer, in whole or in part, for their services.




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