C.F.R. » Title 42 » CHAPTER V—OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—OIG AUTHORITIES › PART 1004—IMPOSITION OF SANCTIONS ON HEALTH CARE PRACTITIONERS AND PROVIDERS OF HEALTH CARE SERVICES BY A QUALITY IMPROVEMENT ORGANIZATION › Subpart C—QIO Responsibilities

42 C.F.R. § 1004.90

Basis for recommended sanction

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The QIO's specific recommendation must be based on documentation provided to the OIG showing its consideration of—

(a) The type of offense involved;

(b) The severity of the offense;

(c) The deterrent value;

(d) The practitioner's or other person's previous sanction record;

(e) The availability of alternative sources of services in the community; and

(f) Any other factors that the QIO considers relevant, such as the duration of the problem.

Notes of Decisions
Cited in 4 cases, 1987–1993 · leading case: Lavapies v. Bowen, 687 F. Supp. 1193 (S.D. Ohio 1988).
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Lavapies v. Bowen, 687 F. Supp. 1193 (S.D. Ohio 1988). · cites it 2× “42 C.F.R. § 1004.90 . If the OIG agrees that a practitioner has violated his or her obligations, the OIG must decide upon an appropriate sanction.”
Papendick v. Bowen, 658 F. Supp. 1425 (W.D. Wis. 1987). · cites it 2× “42 C.F.R. § 1004.90 . If the OIG agrees that a practitioner has violated his or her obligations, the OIG must decide upon an appropriate sanction.”
Anderson v. Sullivan, 959 F.2d 690 (8th Cir. 1992). “42 C.F.R. § 1004.90 (d) (1991). A provider has the right to an administrative review of the Inspector General’s determination.”
Assar v. Crescent Counties Found. for Med. Care, 13 F.3d 215 (7th Cir. 1993). “OIG then reviews the determination and recommended sanction ( 42 C.F.R. § 1004.90 ) and notifies both the provider and the public of its decision ( 42 C.”
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