STATUTORY AUTHORITY
1156 — Failure to meet statutory obligations of practitioners and providers
Failure to meet the statutory obligation to provide services that are economical, medically necessary, of a quality meeting professionally recognised standards, and supported by adequate documentation.
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 an NPI, which is a unique national identifier. A match on that NPI is deterministic.
Verify against the OIG online searchable database →