Michael Donahue

STATUTORY AUTHORITY

1128(b)(16) — Making false statements or misrepresentations of material fact

Knowingly making, or causing to be made, a false statement or misrepresentation of material fact in an application, agreement, bid, or contract to participate or enrol as a provider or supplier.

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.