STATUTORY AUTHORITY
1128(a)(3) — Felony conviction relating to health care fraud
Felony conviction relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct in connection with the delivery of a health care item or service.
What this means for a placement decision
Federal health care programmes will not pay for any item or service furnished by, or at the medical direction of, an excluded party. Civil monetary penalties can accrue per claim submitted. Confirm the identity of this record against the person or entity in front of you before acting on it — the OIG file carries name, date of birth, and where available an NPI for exactly that purpose.
Confirming identity
This record carries no NPI. Identity must be confirmed against the other corroborating fields before it is treated as a match — a name alone is not an identification.
Verify against the OIG online searchable database →