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Code of Federal Regulations (Last Updated: November 8, 2024) |
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Title 42 - Public Health |
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Chapter V—Office of Inspector General-Health Care, Department of Health and Human Services |
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SubChapter B—OIG Authorities |
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Part 1001 - Program Integrity—Medicare and State Health Care Programs |
| Subpart A - General Provisions |
| § 1001.1 - Scope and purpose. |
| § 1001.2 - Definitions. |
| Subpart B - Mandatory Exclusions |
| § 1001.101 - Basis for liability. |
| § 1001.102 - Length of exclusion. |
| Subpart C - Permissive Exclusions |
| § 1001.201 - Conviction relating to program or health care fraud. |
| § 1001.301 - Conviction relating to obstruction of an investigation or audit. |
| § 1001.401 - Conviction relating to controlled substances. |
| § 1001.501 - License revocation or suspension. |
| § 1001.601 - Exclusion or suspension under a Federal or State health care program. |
| § 1001.701 - Excessive claims or furnishing of unnecessary or substandard items and services. |
| § 1001.801 - Failure of HMOs and CMPs to furnish medically necessary items and services. |
| § 1001.901 - False or improper claims. |
| § 1001.951 - Fraud and kickbacks and other prohibited activities. |
| § 1001.952 - Exceptions. |
| § 1001.1001 - Exclusion of entities owned or controlled by a sanctioned person. |
| § 1001.1051 - Exclusion of individuals with ownership or control interest in sanctioned entities. |
| § 1001.1101 - Failure to disclose certain information. |
| § 1001.1201 - Failure to provide payment information. |
| § 1001.1301 - Failure to grant immediate access. |
| § 1001.1401 - Violations of PPS corrective action. |
| § 1001.1501 - Default of health education loan or scholarship obligations. |
| § 1001.1551 - Exclusion of individuals with ownership or control interest in sanctioned entities. |
| § 1001.1552 - xxx |
| § 1001.1601 - Violations of the limitations on physician charges. |
| § 1001.1701 - Billing for services of assistant at surgery during cataract operations. |
| Appendix A to Subpart C of Part 1001 |
| Subpart D - Waivers and Effect of Exclusion |
| § 1001.1801 - Waivers of exclusions. |
| § 1001.1901 - Scope and effect of exclusion. |
| Subpart E - Notice and Appeals |
| § 1001.2001 - Notice of intent to exclude. |
| § 1001.2002 - Notice of exclusion. |
| § 1001.2003 - Notice of proposal to exclude. |
| § 1001.2004 - Notice to State agencies. |
| § 1001.2005 - Notice to State licensing agencies. |
| § 1001.2006 - Notice to others regarding exclusion. |
| § 1001.2007 - Appeal of exclusions. |
| Subpart F - Reinstatement into the Programs |
| § 1001.3001 - Timing and method of request for reinstatement. |
| § 1001.3002 - Basis for reinstatement. |
| § 1001.3003 - Approval of request for reinstatement. |
| § 1001.3004 - Denial of request for reinstatement. |
| § 1001.3005 - Withdrawal of exclusion for reversed or vacated decisions. |