42 CFR Part 1001
PART 1001—PROGRAM INTEGRITY—MEDICARE AND STATE HEALTH CARE PROGRAMS
- PART 1001—PROGRAM INTEGRITY—MEDICARE AND STATE HEALTH CARE PROGRAMS
- Chapter V—Office of Inspector General-Health Care, Department of Health and Human Services › Subchapter B—OIG Authorities
- 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.
- § 1001.1101 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 Making false statements or misrepresentation of material facts.
- § 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.
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