Following the lead of the U.S. Department of Justice’s Yates memo, the Department of Health and Human Services has adopted new guidelines for holding individuals accountable for health care fraud by excluding them from federal programs such as Medicare. Such debarments, in effect, keep individuals from working in the health care industry.
“Exclusion is a remedial measure designed to protect the Federal health care programs from any person whose continued participation in the programs constitutes a risk to the programs and their beneficiaries,” the guidelines state. “Federal health care programs may not pay for any items or services furnished, ordered, or prescribed by an excluded person.”
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