C.F.R. » Title 42 » CHAPTER V—OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—OIG AUTHORITIES › PART 1005—APPEALS OF EXCLUSIONS, CIVIL MONEY PENALTIES AND ASSESSMENTS

42 C.F.R. § 1005.4

Authority of the ALJ

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(a) The ALJ will conduct a fair and impartial hearing, avoid delay, maintain order and assure that a record of the proceeding is made.

(b) The ALJ has the authority to—

(1) Set and change the date, time and place of the hearing upon reasonable notice to the parties;

(2) Continue or recess the hearing in whole or in part for a reasonable period of time;

(3) Hold conferences to identify or simplify the issues, or to consider other matters that may aid in the expeditious disposition of the proceeding;

(4) Administer oaths and affirmations;

(5) Issue subpoenas requiring the attendance of witnesses at hearings and the production of documents at or in relation to hearings;

(6) Rule on motions and other procedural matters;

(7) Regulate the scope and timing of documentary discovery as permitted by this part;

(8) Regulate the course of the hearing and the conduct of representatives, parties, and witnesses;

(9) Examine witnesses;

(10) Receive, rule on, exclude or limit evidence;

(11) Upon motion of a party, take official notice of facts;

(12) Upon motion of a party, decide cases, in whole or in part, by summary judgment where there is no disputed issue of material fact; and

(13) Conduct any conference, argument or hearing in person or, upon agreement of the parties, by telephone.

(c) The ALJ does not have the authority to—

(1) Find invalid or refuse to follow Federal statutes or regulations or secretarial delegations of authority;

(2) Enter an order in the nature of a directed verdict;

(3) Compel settlement negotiations;

(4) Enjoin any act of the Secretary;

(5) Review the exercise of discretion by the OIG to exclude an individual or entity under section 1128(b) of the Act or under part 1003 of this chapter, or determine the scope or effect of the exclusion;

(6) Set a period of exclusion at zero, or reduce a period of exclusion to zero, in any case in which the ALJ finds that an individual or entity committed an act described in section 1128(b) of the Act or under part 1003 of this chapter; or

(7) Review the exercise of discretion by the OIG to impose a CMP, assessment or exclusion under part 1003 of this chapter.

[57 FR 3350, Jan. 29, 1992, as amended at 58 FR 5618, Jan. 22, 1993; 81 FR 88365, Dec. 7, 2016]
Notes of Decisions
Cited in 7 cases (2 in the last 5 years), 1998–2026 · leading case: St. Anthony Hosp. v. United States Dep't of Health & Human Servs., 309 F.3d 680 (10th Cir. 2002).
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St. Anthony Hosp. v. United States Dep't of Health & Human Servs., 309 F.3d 680 (10th Cir. 2002). · cites it 2× “B Title 42 C.F.R. § 1005.4 (b)(12) allows an agency to, “[u]pon motion of a party, decide cases, in whole or in part, by summary judgment where there is no disputed issue of material fact.”
Lasher v. Dep't of Health & Human Servs., 369 F. Supp. 3d 243 (D.C. Cir. 2019). · cites it 3× “In discharging his or her duties to "conduct a fair and impartial hearing, avoid delay, maintain order and assure that a record of the proceeding is made," 42 C.F.R. § 1005.4 (a), the ALJ may, among other things, "[r]eceive, rule on, exclude or limit evidence," 42 C.”
Patel v. Shalala, 17 F. Supp. 2d 662 (W.D. Ky. 1998). “42 C.F.R. § 1005.4 (a). Although the ALJ is not bound by the Federal Rules of Evidence, she must exclude evidence which is irrelevant or immaterial.”
Frounfelter v. Leavitt, 563 F. Supp. 2d 1327 (M.D. Fla. 2008). “§ 1320a-7a(c)(l); that the regulations at 42 C.F.R. §§ 1005.4 (c)(1), (4), and (7) and 42 C.”
In Re Bella Boe, Chloe Coe, Danielle Doe, & Gabriella Goe v. Child.'s Hosp. Colorado., 2026 CO 32 (Colo. 2026). · cites it 2× “¶42 Moreover, CHC could argue that because the exclusion would begin twenty days after the notice of exclusion and because exclusion would cut CHC off from a major funding source and force it to close, it would suffer irreparable harm if it were forced to exhaust administrative…”
Lasher v. Dep't of Health & Human Servs. (D.D.C. 2019). “4 (a), the ALJ may, among other things, “[r]eceive, rule on, exclude or limit evidence,” 42 C.F.R. § 1005.4 (b)(10), and “[c]onduct any conference .”
Fuentes v. Becerra (W.D. Va. 2021). “” 42 C.F.R. § 1005.4 (b)(12). In affirming the ALJ’s decision, the DAB held that there were no material facts in dispute that would preclude summary judgment, that exclusion was required as a matter of law under section 1128(a)(1) of the Act, and that summary judgment was…”
— 42 C.F.R. § 1005.4(c)(4) — 1 case
In Re Bella Boe, Chloe Coe, Danielle Doe, & Gabriella Goe v. Child.'s Hosp. Colorado., 2026 CO 32 (Colo. 2026). “¶42 Moreover, CHC could argue that because the exclusion would begin twenty days after the notice of exclusion and because exclusion would cut CHC off from a major funding source and force it to close, it would suffer irreparable harm if it were forced to exhaust administrative…”
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