Applying for Reinstatement
Reinstatement of an excluded individual or entity is not automatic once the specified period of exclusion ends. In order to participate in the Medicare, Medicaid and all Federal health care programs once the term of exclusion ends, the individual or entity must apply for reinstatement and receive written notice from OIG that reinstatement has been granted.
An individual or entity with a defined period of exclusion (e.g., 5 years, 10 years, etc.) may begin the process of reinstatement 90 days before the end of the period specified in the exclusion notice letter. Requests received earlier than 90 days before the end of the period of exclusion will not be considered.
An individual or entity excluded under section 1128(b)(4) of the Social Security Act, whose period of exclusion is indefinite, may apply for reinstatement when they have regained the license referenced in the exclusion notice. However, under some conditions an individual or entity excluded under section 1128(b)(4) may apply for early reinstatement without regaining the license referenced in the exclusion notice if they have obtained (1) a different health care license in the same state or (2) any health care license in a different state. In addition, reinstatement may be available if the individual excluded under section 1128(b)(4) does not have a valid health care license of any kind in any state and has been excluded for a minimum period of 3 years, following the OIG's consideration of all the factors specified in the regulations. This process for early reinstatement is not available to an individual excluded under section 1128(b)(4) if the individual's license was revoked, suspended, or otherwise lost or surrendered for reasons relating to patient abuse or neglect. Additional information regarding the requirements for early reinstatement is available at 42 C.F.R. 1001.501(c).
Obtaining a provider number from a Medicare contractor, a State health care program or a Federal health care program does not reinstate an individual's or entity's eligibility to participate in those programs. Additional information regarding the reinstatement process is available at 42 C.F.R. 1001.3001-3005.
To apply for reinstatement, an excluded individual or entity must send a written request to OIG at the address or fax number below. Upon receipt of a request for reinstatement, if the individual is eligible to apply for reinstatement, OIG will mail Statement and Authorization forms that must be completed, notarized and returned to the OIG via mail. The forms must contain original signatures. Once the information contained in these forms has been evaluated, a written notification of OIG's final decision on reinstatement will be provided via mail. This process generally requires up to 120 days to complete, but can take longer. If reinstatement is denied, the excluded individual or entity is eligible to reapply after 1 year.
To apply for reinstatement, the excluded individual or entity must send a written request to:
HHS, OIG, OI
Attn: Exclusions
P.O. Box 23871
Washington, DC 20026
Fax: (202) 691-2298
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