You have only 60 days from your notice of Medicare exclusion to appeal the HHS OIG decision. Given that Medicare exclusion can be career ending, you should appeal your Medicare exclusion by requesting a hearing before an Administrative Law Judge as soon as possible.
As with reinstatement, you essentially have one shot at an appeal, and you should consider hiring a Medicare exclusion reinstatement attorney to appeal the Medicare exclusion decision. Pursuant to 42 CFR 402.214, you must request a hearing within 60 days from the receipt of the notice of exclusion. The request for a Medicare exclusion hearing should be completed by an experienced health law attorney and must include:
- A statement as to the specific issues the individual takes with the Medicare exclusion
- Basis for the disagreement of the Office of Inspector General’s decision
- Reasons why the proposed length of exclusion should be modified
- Reasons, if applicable, why the health or safety of Medicare beneficiaries does not warrant exclusion
If you do not file a timely request for a hearing, you may lose your right to appeal. Therefore, it is imperative that you file your request for a Medicare exclusion hearing within 60 days and ensure that it contains all the necessary information. Failure to properly petition for a Medicare exclusion hearing will result in loss of your right to appeal.
If you are granted a hearing, your attorney will be able to present arguments to an Administrative Law Judge and seek reinstatement.
If the Medicare exclusion was in error, you will be reinstated.