Often, Nurse Practitioners hold another license, like an LVN license or a CNA license and so when faced with an Accusation from the BRN calling for the revocation of their NP license, some nurses figure they will just surrender one and use the other.
The problem is that if a nurse surrenders a license following an accusation, they will be placed on the Health and Human Services (HHS) Federal Office of Inspector General (OIG) List of Excluded Individuals/Entities or the state’s version: the Medi-Cal Suspended and Ineligible Provider List.
WHAT IS THE OIG OR MEDI-CAL EXCLUSION LIST?
These exclusion lists are exactly what they sound like they are: they exclude a provider from working in any facility that receives Federal Medicare or State Medi-Cal funding, so…. Everywhere. This means that if you have surrendered your Nurse Practitioner’s license or had your NP license revoked, you will not be able to work in any capacity, with any license in any healthcare field. Even nurses lucky enough to find positions within a hospital that do not require any sort of license at all, like purely administrative positions, are excluded because the hospitals are prohibited from employing excluded individuals and will face sanctions and fines if they do so.
WHO GETS PLACED ON THE OIG OR MEDI-CAL EXCLUSION LISTS?
In California, Medi-Cal law, Welfare, and Institutions Code (W&I Code), sections 14043.6 and 14123, mandate that the Department of Health Care Services (DHCS) suspend a Medi-Cal provider of health care services (provider) from participation in the Medi-Cal program when the individual or entity has:
- Been convicted of a felony
- Been convicted of a misdemeanor involving fraud, abuse of the Medi-Cal program or any patient, or otherwise substantially related to the qualifications, functions, or duties of a provider of service
- Been suspended from the federal Medicare or Medicaid programs for any reason
- Lost or surrendered a license, certificate, or approval to provide health care
- Breached a contractual agreement with the Department that explicitly specifies inclusion on this list as a consequence of the breach.
The suspension is automatic when any of the above events occur, and suspended Medi-Cal providers will not be entitled to a hearing under the California Administrative Procedures Act.
HOW DO I GET OFF THE OIG OR MEDI-CAL EXCLUSION LISTS?
While there are ways to appeal inclusion on the OIG List of Excluded Individuals/Entities or the state’s version: the Medi-Cal Suspended and Ineligible Provider List, they are complex processes. If you are on the Federal OIG’s List, you cannot get off of the Medi-Cal list without first getting removed from the OIG’s list. There are also waiting periods and specific time frames to contend with for each. The “simplest” way to be removed from the OIG or Medi-Cal lists is to have the license at issue reinstated, but this is another long and expensive, drawn-out process. For more information on Petitioning for Reinstatement of an NP license, click here.
If you are a nurse practitioner and are considering surrendering your NP license in lieu of facing license discipline or revocation, please make sure that you are aware of the ramifications. In reality, you will not be able to work in healthcare, in any capacity, at all. If you are multiply licensed, those other licenses will be useless to you because you will be an excluded provider under the OIG List of Excluded Individuals/Entities or the Medi-Cal Suspended and Ineligible Provider List and those lists trump the license.
If you are a registered nurse practitioner and you are facing an Accusation calling for the revocation of your NP license, it is far simpler and FAR less expensive and time-consuming to argue it on the front end and have the revocation reduced to a lower level discipline like probation or even suspension. For example, defending an Accusation in a stipulated settlement is about $4000.00 with our attorneys, depending on the underlying complaint. We have a 99% success rate in keeping our clients’ licenses from being revoked. The process is over and done within about 9 months. A Petition for Reinstatement of a revoked license is about $7000.00 and requires a 2 to 3-year waiting period. The appeals to the OIG List of Excluded Individuals/Entities or the Medi-Cal Suspended and Ineligible Provider List can be another $2000 to $4000 and can take months. While defending an accusation is no picnic, it is a far sunnier outcome than the alternative. For more on defending a BRN Accusation, click here.
If you have truly decided that healthcare is no longer for you and you do not plan in ever working in healthcare in the future, then the surrender of your license is a viable choice. For anyone else, it creates an unending nightmare of bureaucratic hoop-jumping and will cost tens of thousands of dollars to navigate. If you have already been placed on the OIG List of Excluded Individuals/Entities or the Medi-Cal Suspended and Ineligible Provider List and are looking for someone to help you, please contact our team.