Working with Federal and State Partners
HHS-OIG has the authority to exclude individuals and entities from Federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud. Those that are excluded can receive no payment from Federal health care programs for any items or services they furnish, order, or prescribe.
State health care professional licensing authorities (such as licensing boards, commissions, and Health Departments) can submit referrals using the e-mail address: [email protected]. Only certain actions by state licensing authorities render an individual or entity eligible for exclusion. For more information on what state licensing authority actions make an individual or entity eligible for exclusion, visit Working with State Health Care Professional Licensing Authorities.
Federal agencies, MFCUs, and other state partners use the Exclusion Referrals portal to submit the necessary documentation on individuals or entities who should be considered for exclusion. If non-MFCU State and local prosecutors are going to submit a significant volume of referrals, they can also register to use the Exclusion Referral Portal. If they will only be rarely submitting a referral, they can submit the referral using the e-mail address: [email protected]. For more information on excludable convictions and documentation, visit Referrals for Exclusion Based on Convictions.