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Nurses Hit Hardest by Medicare and Medicaid Exclusions

Publisher: Bloomberg BNA's Health Care Fraud Report
July 19, 2017

Eric Fader was quoted in an article, "Nurses Hit Hardest by Medicare and Medicaid Exclusions," published in Bloomberg BNA's Health Care Fraud Report. According to the article, 30,123 nurses were currently excluded from participation in the Medicare and Medicaid programs as of 2016, compared to 1,588 physicians, although there are only 3-4 times as many licensed nurses in the U.S. compared to licensed physicians. Fader told Bloomberg BNA that the disparity in the numbers of exclusions, which prevent individuals or entities from being paid by Medicare, Medicaid, or any other federal health-care program, may be due in part to different approaches to seeking reinstatement at the end of the mandatory exclusion period. "Perhaps some percentage of nurses and other lower-level health-care providers who are excluded get jobs doing other things, either in health care or in unrelated fields, during their exclusion period and then never bother applying for reinstatement," Fader told Bloomberg BNA. In contrast, Fader added, a physician who is excluded would almost certainly apply for reinstatement at the earliest possible moment, because the ability to provide services to Medicare and Medicaid patients is critical for physicians.


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