C.F.R. » Title 42 » CHAPTER V—OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—OIG AUTHORITIES › PART 1002—PROGRAM INTEGRITY—STATE-INITIATED EXCLUSIONS FROM MEDICAID › Subpart C—Procedures for State-Initiated Exclusions

42 C.F.R. § 1002.210

General authority

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The State agency must have administrative procedures in place that enable it to exclude an individual or entity for any reason for which the Secretary could exclude such individual or entity under parts 1001 or 1003 of this chapter. The period of such exclusion is at the discretion of the State agency.

Notes of Decisions
Cited in 4 cases, 1996–2013 · leading case: Goldstar Medical Services, Inc. v. Department of Social Services
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Goldstar Medical Services, Inc. v. Department of Social Services (2008) conn · cites it 2× “” One such federal regulation with which state agencies must comply is 42 C.F.R. § 1002.210 , which provides in relevant part that a state “must have administrative procedures in place that enable it to exclude an individual or entity for any reason for which the Secretary [of…”
Koch v. Sheehan (2013) ny “Indeed, federal law requires, as a condition of receipt of federal funding, that states institute administrative procedures enabling them to exclude Medicaid providers for furnishing substandard services, regardless of whether those services were supplied to Medicaid recipients…”
KOCH, D.O., ERIC J. v. SHEEHAN, JAMES G. (2012) nyappdiv “701 [a] [2]), and further require that the state agency have the same authority to do so (see 42 CFR 1002.210). The DOH regulations provide several bases for terminating or excluding a provider from the Medicaid Program.”
Levin v. Childers (1996) ca6 “Childers’ position might very well have read the Physician Services Manual as pertaining to the exclusion of an individual under procedures put in place *48 pursuant to 42 C.F.R. § 1002.210 , which reads as follows: “The State agency must have administrative procedures in place…”
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