What’s the difference between a mandatory exclusion and a permissive exclusion?
What is the difference between mandatory exclusion and permissive exclusion?
Mandatory Exclusion – The OIG is required to automatically exclude individuals and entities that are
convicted of a program related crime or a crime of patient abuse or neglect. Other mandated exclusions
include when an individual or entity is convicted of a felony related to a controlled substance or a felony
related to health care fraud.
Permissive Exclusion – The OIG may use discretion in excluding individuals and entities for other reasons.
Permissive exclusions may or may not result as a result of lying on an enrollment application, failure to
repay health education loans, loss of a state license to practice, or conviction of certain misdemeanor