According to a newly proposed rule from a top federal watchdog, long term care providers who obstruct audits could have their Medicare and Medicaid certifications revoked. The Department of Health and Human Services Office of Inspector General has created the rule to implement an ACA provision which allows the government to remove providers found guilty of obstructing audits. Regulations set an “aggravating factor” of $1,500 or $5,000 when determining the length of the Medicare or Medicaid exclusion (depending on the type of wrongdoing). Thus, “lengthier exclusions apply for acts that resulted in or were intended to result in financial losses to the government above these thresholds.” The new rule proposes increasing the aggravating factor to $15,000.
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