C.F.R. » Title 42 » CHAPTER V—OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—OIG AUTHORITIES › PART 1001—PROGRAM INTEGRITY—MEDICARE AND STATE HEALTH CARE PROGRAMS › Subpart A—General Provisions

42 C.F.R. § 1001.1

Scope and purpose

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(a) The regulations in this part specify certain bases upon which individuals and entities may, or in some cases must, be excluded from participation in Medicare, Medicaid and all other Federal health care programs. They also state the effect of exclusion, the factors that will be considered in determining the length of any exclusion, the provisions governing notices of exclusions, and the process by which an excluded individual or entity may seek reinstatement into the programs.

(b) The regulations in this part are applicable to and binding on the Office of Inspector General (OIG) in imposing and proposing exclusions, as well as to Administrative Law Judges (ALJs), the Departmental Appeals Board (DAB), and federal courts in reviewing the imposition of exclusions by the OIG (and, where applicable, in imposing exclusions proposed by the OIG).

[57 FR 3330, Jan. 29, 1992, as amended at 58 FR 5618, Jan. 22, 1993; 64 FR 39426, July 22, 1999]
Notes of Decisions
Cited in 5 cases, 1989–2019 · leading case: Pennington v. Thompson, 249 F. Supp. 2d 931 (W.D. Tenn. 2003).
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Pennington v. Thompson, 249 F. Supp. 2d 931 (W.D. Tenn. 2003). “1998) (citing 42 C.F.R. § 1001.1 et seq.). 4 . The DAB found that Plaintiff had failed to timely offer his plea and sentencing transcripts in support of his appeal.”
Hilst v. Bowen, 874 F.2d 725 (10th Cir. 1989). “1988); 42 C.F.R. § 1001.1 et seq. As in Chilicky , this remedy includes an elabo *728 rate administrative hearing, and administrative and judicial review.”
Patel v. Shalala, 17 F. Supp. 2d 662 (W.D. Ky. 1998). “42 C.F.R. § 1001.1 et seq. When the statute requires the imposition of a minimum five year exclusion due to conviction of a program-related crime, the regulations permit the Secretary to increase the duration of the exclusion if specified aggravating factors are found to exist.”
Lasher v. Dep't of Health & Human Servs., 369 F. Supp. 3d 243 (D.C. Cir. 2019). “" 42 C.F.R. § 1001.1 (a). One such basis is an individual's conviction of a program-related offense: The Secretary shall exclude .”
Lasher v. Dep't of Health & Human Servs. (D.D.C. 2019). “” 42 C.F.R. § 1001.1 (a). One such basis is an individual’s conviction of a program-related offense: The Secretary shall exclude .”
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