Code of Federal Regulations (Last Updated: November 8, 2024) |
Title 42 - Public Health |
Chapter V - Office of Inspector General-Health Care, Department of Health and Human Services |
SubChapter B - OIG Authorities |
Part 1001 - Program Integrity - Medicare and State Health Care Programs |
Subpart C - Permissive Exclusions |
§ 1001.1551 - Exclusion of individuals with ownership or control interest in sanctioned entities.
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§ 1001.1551 Exclusion of individuals with ownership or control interest in sanctioned entities.
(a) Circumstance for exclusion. The OIG may exclude any individual who—
(1) Has a direct or indirect ownership or control interest in a sanctioned entity, and who knows or should know (as defined in section 1128A(i)(6) of the Act) of the action constituting the basis for the conviction or exclusion set forth in paragraph (b) of this section; or
(2) Is an officer or managing employee (as defined in section 1126(b) of the Act) of such an entity.
(b) For purposes of paragraph (a) of this section, the term “sanctioned entity” means an entity that—
(1) Has been convicted of any offense described in §§ 1001.101 through 1001.401 of this part; or
(2) Has been terminated or excluded from participation in Medicare, Medicaid and all other Federal health care programs.
(c) Length of exclusion.
(1) If the entity has been excluded, the length of the individual's exclusion will be for the same period as that of the sanctioned entity.
(2) If the entity was not excluded, the length of the individual's exclusion will be determined by considering the factors that would have been considered if the entity had been excluded.
(3) An individual excluded under this section may apply for reinstatement in accordance with the procedures set forth in § 1001.3001.
[63 FR 46689, Sept. 2, 1998. Redesignated and amended at 82 FR 4115, Jan. 12, 2017]