More Reasons Not to Voluntarily Relinquish Your Professional License or Fail to Appeal an Exclusion Action

Thursday, March 15, 2012

Previously, I have written articles and blogs on why a physician, dentist, pharmacist, nurse, psychologist, mental health counselor or other licensed health professional should never agree to voluntarily relinquish his or her license after any notice of a possible investigation being opened. This is treated the same as if the state licensing agency had revoked that license for cause. This applies even if the license is in another state, is inactive, or has expired.

The consequences of this include the action that will surely follow from the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) to exclude that professional from the Medicare Program. Of course, this exclusion means any federal health care program, including participation in TRICARE/CHAMPUS, Veterans Administration (VA) program, Public Health Service (PHS) programs, Indian Health Service programs, U.S. Postal Service (USPS) health programs, and the state Medicaid program.

However, 42 C.F.R. § 1001.2006 requires that that the Department of Health and Human Services (HHS) provide notice of a health professional's exclusion from the Medicare Program to the following, among others:

(1) Medicare beneficiaries;

(2) The public;

(3) Any entity in which the excluded individual is known to be serving as an employee, administrator, operator, or in which the individual is serving in any other capacity and is receiving payment for providing services;

(4) State Medicaid Fraud Control Units;

(5) Utilization and Quality Control Quality Improvement Organizations;

(6) Hospitals, skilled nursing facilities, home health agencies and health maintenance organizations;

(7) Medical societies and other professional organizations;

(8) Contractors, health care prepayment plans, private insurance companies and other affected agencies and organizations;

(9) The National Practitioner Data Bank.

(10) Other Departmental operating divisions, Federal agencies, and other agencies or organizations, as appropriate.

One should think not twice but three times before voluntarily relinquishing a health professional license of any kind, medical license, pharmacy license, nursing license, psychology license, social work license, mental health counselor license, or any other, once there is some notice that an investigation has commenced or that a complaint has been received.


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