98-28736. Health Care Programs: Fraud and Abuse; Revised OIG Exclusion Authorities Resulting From Public Law 104-191; Correction  

  • [Federal Register Volume 63, Number 209 (Thursday, October 29, 1998)]
    [Rules and Regulations]
    [Pages 57918-57919]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 98-28736]
    
    
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    DEPARTMENT OF HEALTH AND HUMAN SERVICES
    
    Office of Inspector General
    
    42 CFR Part 1001
    
    
    Health Care Programs: Fraud and Abuse; Revised OIG Exclusion 
    Authorities Resulting From Public Law 104-191; Correction
    
    AGENCY: Office of Inspector General (OIG), HHS.
    
    ACTION: Final Rule; correcting amendment.
    
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    SUMMARY: This document contains corrections to the final regulations 
    which were published in the Federal Register of Wednesday, September 2, 
    1998 (63 FR 46676). The regulations addressed revisions to the OIG's 
    administrative sanction authorities resulting from the Health Insurance 
    Portability and Accountability Act of 1996, along with technical and 
    conforming changes to the OIG exclusion authorities. A number of 
    inadvertent errors appeared in the text of the regulations relating to 
    program integrity for the Medicare and State health care programs. As a 
    result, we are making corrections to two sections addressing the length 
    of exclusion and notice of intent to exclude in order to assure the 
    technical correctness of these regulations.
    
    EFFECTIVE DATE: October 29, 1998.
    
    FOR FURTHER INFORMATION CONTACT: Joel Schaer, (202) 619-0089, OIG 
    Regulations Officer.
    
    SUPPLEMENTARY INFORMATION: The HHS Office of Inspector General (OIG) 
    issued final regulations on September 2, 1998 (63 FR 46676) that 
    addressed revisions to the OIG's administrative sanction authorities 
    resulting from the Health Insurance Portability and Accountability Act 
    of 1996, along with technical and conforming changes to the OIG 
    exclusion authorities. In that final rule, two inadvertent errors 
    appeared in 42 CFR part 1001 and are now being corrected.
        In Sec. 1001.2001, addressing the elimination of in-person hearings 
    prior to when an exclusion is proposed, the regulatory language was 
    intended to be consistent with the preamble discussion on page 46682, 
    and state that when an exclusion was proposed under Sec. 1001.701 or 
    Sec. 1001.801, the individual or entity would be permitted to request, 
    in conjunction with their written submission, an opportunity to present 
    oral argument to an OIG official. In order to correctly emphasize that 
    a request to present oral argument to an OIG official can only be made 
    in cases involving exclusion under sections 1128(b)(6) (B) and (C) of 
    the Social Security Act, we are correcting the regulatory text that was 
    set forth in Sec. 1001.2001.
        In addition, we are correcting a typographical error that appeared 
    on page 46686, column 3 in Sec. 1001.102(b)(4). Specifically, in line 4 
    of paragraph (b)(4), the words ``or behavior'' are being corrected to 
    read as ``of behavior.''
    
    List of Subjects in 42 CFR Part 1001
    
        Administrative practice and procedure, Fraud, Grant programs--
    health, Health facilities, Health professions, Maternal and child 
    health, Medicaid, Medicare, Social security.
    
        Accordingly, 42 CFR part 1001 is corrected by making the following 
    correcting amendments:
    
    PART 1001--PROGRAM INTEGRITY--MEDICARE AND STATE HEALTH CARE 
    PROGRAMS
    
        1. The authority citation for part 1001 continues to read as 
    follows:
    
        Authority: 42 U.S.C. 1302, 1320a-7, 1320a-7b, 1395u(j), 
    1395y(d), 1395y(e), 1395cc(b)(2) (D), (E) and (F), and 1395hh; and 
    sec. 2455, Pub.L. 103-355, 108 Stat. 3327 (31 U.S.C. 6101 note).
    
        2. Section 1001.102 is amended by republishing paragraph (b) 
    introductory text and by revising paragraph (b)(4) to read as follows:
    
    
    Sec. 1001.102  Length of exclusion.
    
    * * * * *
        (b) Any of the following factors may be considered to be 
    aggravating and a basis for lengthening the period of exclusion--
    * * * * *
        (4) In convictions involving patient abuse or neglect, the action 
    that resulted in the conviction was premeditated, was part of a 
    continuing pattern of behavior, or consisted of non-consensual sexual 
    acts;
    * * * * *
        3. Section 1001.2001 is amended by revising paragraph (a), by 
    redesignating paragraphs (b) and (c) as paragraphs (c) and (d), 
    respectively, and by adding a new paragraph (b) to read as follows:
    
    
    Sec. 1001.2001  Notice of intent to exclude.
    
        (a) Except as provided in paragraph (c) of this section, if the OIG 
    proposes to exclude an individual or entity in accordance with subpart 
    C of this part, or in accordance with subpart B of this part where the 
    exclusion is for a period exceeding 5 years, it will send written 
    notice of its intent, the basis for the
    
    [[Page 57919]]
    
    proposed exclusion and the potential effect of an exclusion. Within 30 
    days of receipt of notice, which will be deemed to be 5 days after the 
    date on the notice, the individual or entity may submit documentary 
    evidence and written argument concerning whether the exclusion is 
    warranted and any related issues.
        (b) If the OIG proposes to exclude an individual or entity under 
    the provisions of Sec. 1001.701 or 1001.801 of this part, in 
    conjunction with the submission of documentary evidence and written 
    argument, an individual or entity may request an opportunity to present 
    oral argument to an OIG official.
    * * * * *
        Dated: October 20, 1998.
    Joel Schaer,
    OIG Regulations Officer.
    [FR Doc. 98-28736 Filed 10-28-98; 8:45 am]
    BILLING CODE 4150-04-P
    
    
    

Document Information

Effective Date:
10/29/1998
Published:
10/29/1998
Department:
Health and Human Services Department
Entry Type:
Rule
Action:
Final Rule; correcting amendment.
Document Number:
98-28736
Dates:
October 29, 1998.
Pages:
57918-57919 (2 pages)
PDF File:
98-28736.pdf
CFR: (4)
42 CFR 2455
42 CFR 1001.102
42 CFR 1001.801
42 CFR 1001.2001