Permissive Exclusions

  1. Law
  2. CFR 42
  3. Public Health
  4. Office of Inspector General-Health Care, Department of Health and Human Services
  5. OIG Authorities
  6. Program Integrity - Medicare and State Health Care Programs
  7. Permissive Exclusions

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Section
1001.201

Conviction relating to program or health care fraud.

Section
1001.301

Conviction relating to obstruction of an investigation or audit.

Section
1001.401

Conviction relating to controlled substances.

Section
1001.501

License revocation or suspension.

Section
1001.601

Exclusion or suspension under a Federal or State health care program.

Section
1001.701

Excessive claims or furnishing of unnecessary or substandard items and services.

Appendix
Appendix A to Subpart C of Part 1001

Appendix A to Subpart C of Part 1001

Section
1001.801

Failure of HMOs and CMPs to furnish medically necessary items and services.

Section
1001.901

False or improper claims.

Section
1001.951

Fraud and kickbacks and other prohibited activities.

Section
1001.952

Exceptions.

Section
1001.1001

Exclusion of entities owned or controlled by a sanctioned person.

Section
1001.1101

Failure to disclose certain information.

Section
1001.1201

Failure to provide payment information.

Section
1001.1301

Failure to grant immediate access.

Section
1001.1401

Violations of PPS corrective action.

Section
1001.1501

Default of health education loan or scholarship obligations.

Section
1001.1551

Exclusion of individuals with ownership or control interest in sanctioned entities.

Section
1001.1552

Making false statements or misrepresentation of material facts.

Section
1001.1601

Violations of the limitations on physician charges.

Section
1001.1701

Billing for services of assistant at surgery during cataract operations.