CINXE.COM

<!DOCTYPE html> <html> <head>  <script async src="https://www.googletagmanager.com/gtag/js?id=G-W5DCJS81Y5"></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-W5DCJS81Y5'); </script> <meta name="language" content="English"> <meta http-equiv="Content-Type" content="text/html;charset=ISO-8859-1"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <link rel="stylesheet" href="/uswds/css/uswds.css"> <link rel="stylesheet" media="print" href="/uswds/css/print.css"> <link rel="shortcut icon" href="/images/favicon.ico" type="image/x-icon" /> <meta name="viewport" content="width=device-width, initial-scale=1"> <script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/1.4.2/jquery.min.js"></script> <script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/3.3.1/jquery.min.js"></script> <script type="text/javascript" src="/uswds/js/rotator.js"></script> <script type="text/javascript" src="/uswds/js/subnav.js"></script> <script type="text/javascript" src="/uswds/js/jquery.sticky-kit.min.js"></script> <link rel="stylesheet" href="/uswds/js/jquery.fancybox.min.css" /> <script type="text/javascript" src="/uswds/js/jquery.fancybox.min.js"></script> <script type="text/javascript" src="/layout/js/tooltip/jquery.qtip.js"></script> <script type="text/javascript" src="/uswds/js/audioplayer.min.js"></script> <link rel="stylesheet" href="/uswds/js/audioplayer.css" /> <script type="text/javascript" src="/uswds/js/tooltipster/js/tooltipster.bundle.min.js"></script> <link rel="stylesheet" href="/uswds/js/tooltipster/css/tooltipster.bundle.min.css" /> <script type="text/javascript" src="/uswds/js/readmore.js"></script>  <script>$( function() { $( 'audio' ).audioPlayer(); } );</script> <script> $( function() { $(".sticker").stick_in_parent(); } ); </script> <script type="application/ld+json"> { "@context" : "http://schema.org", "@type" : "Organization", "name" : "HHS-OIG", "url" : "https://oig.hhs.gov", "sameAs" : [ "https://www.facebook.com/OIGatHHS/", "https://twitter.com/OIGatHHS/", "https://www.youtube.com/user/OIGatHHS", "https://www.linkedin.com/company/hhs-office-of-the-inspector-general"] } </script> <title>Exclusions Authorities | Exclusions | Office of Inspector General | U.S. Department of Health and Human Services</title> <meta name="keywords" content="Office of Inspector General | U.S. Department of Health and Human Services" /> <meta name="description" content="Office of Inspector General | U.S. Department of Health and Human Services" /> </head> <body>  <noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-JLFR" height="0" width="0" style="display:none;visibility:hidden" title="googletagmanager"></iframe></noscript> <script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({"gtm.start":new Date().getTime(),event:"gtm.js"});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!="dataLayer"?"&l="+l:"";j.async=true;j.src="//www.googletagmanager.com/gtm.js?id="+i+dl;f.parentNode.insertBefore(j,f);})(window,document,"script","dataLayer","GTM-JLFR");</script>  <a class="usa-skipnav" href="#main-content">Skip to main content</a> <section class="usa-banner"> <div class="usa-accordion"> <header class="usa-banner-header"> <div class="usa-grid usa-banner-inner"> <img src="/uswds/img/favicons/favicon-57.png" alt="U.S. flag"> <p>An official website of the United States government</p> <button class="usa-accordion-button usa-banner-button" aria-expanded="false" aria-controls="gov-banner"> <span class="usa-banner-button-text">Here's how you know</span> </button> </div> </header> <div class="usa-banner-content usa-grid usa-accordion-content" id="gov-banner"> <div class="usa-banner-guidance-gov usa-width-one-half"> <img class="usa-banner-icon usa-media_block-img" src="/uswds/img/icon-dot-gov.svg" alt="Dot gov"> <div class="usa-media_block-body"> <p> <strong>The .gov means it's official.</strong> <br> Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site. </p> </div> </div> <div class="usa-banner-guidance-ssl usa-width-one-half"> <img class="usa-banner-icon usa-media_block-img" src="/uswds/img/icon-https.svg" alt="Https"> <div class="usa-media_block-body"> <p> <strong>The site is secure.</strong> <br> The <strong>https://</strong> ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. </p> </div> </div> </div> </div> </section>  <header class="usa-header usa-header-extended" role="banner" style="background:#112E51;"> <div class="usa-navbar"> <div class="usa-logo" id="extended-logo"> <em class="usa-logo-text"> <a href="/" title="Home" aria-label="Home"> <img src="/uswds/img/hhsoig-banner-logo.png" class="banner-logo-image" alt="U.S. Department of Health and Human Services, Office of Inspector General" /> <span class="banner-logo-text">HHS <span class="oig-banner" style="color:#fff">Office of Inspector General</span></span> </a> </em> </div> <button class="usa-menu-btn">Menu</button> </div> <nav role="navigation" class="usa-nav"> <div class="usa-nav-inner"> <button class="usa-nav-close"> <img src="/uswds/img/close.svg" alt="close"> </button> <ul class="usa-nav-primary usa-accordion"> <li><button class="usa-accordion-button usa-nav-link" aria-expanded="false" aria-controls="extended-nav-section-one"> <span onclick="_sz.push(['event', 'MAIN_NAV-ABOUT', 'CLICK', 'NAV-HEADING']);">About OIG</span> </button> <ul id="extended-nav-section-one" class="usa-nav-submenu"> <li><a href="/about-oig/about-us/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-ABOUT', 'CLICK', 'ABOUT-OVERVIEW']);">About OIG Overview</a></li> <li><a href="/about-oig/about-us/leadership.asp" onclick="_sz.push(['event', 'MAIN_NAV-ABOUT', 'CLICK', 'LEADERSHIP']);">Leadership</a></li> <li><a href="/about-oig/organization-chart/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-ABOUT', 'CLICK', 'ORGCHART']);">Organization Chart</a></li> <li><a href="/about-oig/contact-us/" onclick="_sz.push(['event', 'MAIN_NAV-ABOUT', 'CLICK', 'CONTACT']);">Contact Us</a></li> <li><a href="/about-oig/oig-budget/" onclick="_sz.push(['event', 'MAIN_NAV-ABOUT', 'CLICK', 'BUDGET']);">Budget</a></li> <li><a href="/reports-and-publications/strategic-plan/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-ABOUT', 'CLICK', 'STRATEGIC-PLAN']);">Strategic Plan</a></li> <li><a href="/about-oig/downloadable-resources-and-applications/" onclick="_sz.push(['event', 'MAIN_NAV-ABOUT', 'CLICK', 'RESOURCES-APPLICATIONS']);">Downloadable Resources and Applications</a></li> </ul></li> <li><button class="usa-accordion-button usa-nav-link" aria-expanded="false" aria-controls="extended-nav-section-two"> <span onclick="_sz.push(['event', 'MAIN_NAV-REPORTS', 'CLICK', 'NAV-HEADING']);">Reports</span> </button> <ul id="extended-nav-section-two" class="usa-nav-submenu"> <li><a href="/reports/" onclick="_sz.push(['event', 'MAIN_NAV-REPORTS', 'CLICK', 'REPORTS-OVERVIEW']);">Reports</a></li> <li><a href="/reports/all/" onclick="_sz.push(['event', 'MAIN_NAV-REPORTS', 'CLICK', 'All-REPORTS']);">All Reports and Publications</a></li> <li><a href="/reports-and-publications/workplan/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-REPORTS', 'CLICK', 'WORKPLAN']);">Work Plan</a></li> <li><a href="/reports/recommendations/" onclick="_sz.push(['event', 'MAIN_NAV-REPORTS', 'CLICK', 'RECOMMENDATIONS']);">Recommendations</a></li> <li><a href="/reports-and-publications/featured-topics/" onclick="_sz.push(['event', 'MAIN_NAV-REPORTS', 'CLICK', 'FEATURED-TOPICS']);">Featured Topics</a></li> <li><a href="/about-oig/oig-budget/" onclick="_sz.push(['event', 'MAIN_NAV-REPORTS', 'CLICK', 'BUDGET']);">Budget</a></li> <li><a href="/reports-and-publications/federal-register-notices/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-REPORTS', 'CLICK', 'FEDERAL-REGISTER']);">Federal Register</a></li> </ul></li> <li><button class="usa-accordion-button usa-nav-link" aria-expanded="false" aria-controls="extended-nav-section-three"> <span onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'NAV-HEADING']);">Fraud</span> </button> <ul id="extended-nav-section-three" class="usa-nav-submenu"> <li><a href="/fraud/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'FRAUD-OVERVIEW']);">Fraud Overview</a></li> <li><a href="/fraud/report-fraud/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'SUBMIT-COMPLAINT']);">Submit a Hotline Complaint</a></li> <li><a href="/fraud/enforcement/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'EAS']);">Enforcement Actions</a></li> <li><a href="/fraud/fugitives/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'FUGITIVES']);">Fugitives</a></li> <li><a href="/fraud/child-support-enforcement/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'CHILD-SUPPORT']);">Child Support Enforcement</a></li> <li><a href="/fraud/medicaid-fraud-control-units-mfcu/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'MFCU']);">Medicaid Fraud Control Units</a></li> <li><a href="/fraud/state-false-claims-act-reviews/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'SFCA-REVIEWS']);">State False Claims Act Reviews</a></li> <li><a href="/fraud/consumer-alerts/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'CONSUMER-ALERTS']);">Consumer Alerts</a></li> <li><a href="/fraud/strike-force/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'STRIKE-FORCE']);">Medicare Fraud Strike Force</a></li> <li><a href="/fraud/fraud-risk-spectrum/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'FRAUD-RISK-SPECTRUM']);">Fraud Risk and Heightened Scrutiny</a></li> <li><a href="/fraud/whistleblower/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'WHISTLEBLOWER']);">Whistleblower Protection Coordinator</a></li> <li><a href="/fraud/contract-fraud/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'CONTRACT-FRAUD']);">Contract Fraud</a></li> <li><a href="/fraud/grant/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'GRANT-FRAUD']);">Grant Fraud</a></li> <li><a href="/fraud/care/" onclick="_sz.push(['event', 'MAIN_NAV-FRAUD', 'CLICK', 'OP-CARE']);">Operation CARE</a></li> </ul></li> <li><button class="usa-accordion-button usa-nav-link" aria-expanded="false" aria-controls="extended-nav-section-four"> <span onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'NAV-HEADING']);">Compliance</span> </button> <ul id="extended-nav-section-four" class="usa-nav-submenu"> <li><a href="/compliance/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'COMPLIANCE-OVERVIEW']);">Compliance</a></li> <li><a href="/compliance/compliance-guidance/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'COMPLIANCE-GUIDANCE']);">Compliance Guidance</a></li> <li><a href="/compliance/corporate-integrity-agreements/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'CIA']);">Corporate Integrity Agreements</a></li> <li><a href="/compliance/advisory-opinions/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'ADVISORY-OPINIONS']);">Advisory Opinions</a></li> <li><a href="/compliance/accountable-care-organizations/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'ACO']);">Accountable Care Organizations</a></li> <li><a href="/compliance/open-letters/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'OPEN-LETTERS']);">Open Letters</a></li> <li><a href="/compliance/rat-stats/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'RAT-STATS']);">RAT-STATS - Statistical Software</a></li> <li><a href="/compliance/safe-harbor-regulations/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'SAFE-HARBOR']);">Safe Harbor Regulations</a></li> <li><a href="/compliance/self-disclosure-info/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'SELF-DISCLOSURE']);">Self-Disclosure Information</a></li> <li><a href="/compliance/alerts/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'SPECIAL-ALERTS']);">Special Fraud Alerts, Bulletins, and Other Guidance</a></li> <li><a href="/compliance/physician-education/" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'ROADMAP']);">A Roadmap for New Physicians</a></li> <li><a href="/compliance/single-audits/" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'SINGLE-AUDITS']);">Single Audits</a></li> <li><a href="https://oig.hhs.gov/faqs/" onclick="_sz.push(['event', 'MAIN_NAV-COMPLIANCE', 'CLICK', 'FAQ']);">Frequently Asked Questions (FAQs)</a></li> </ul></li> <li><button class="usa-accordion-button usa-nav-link" aria-expanded="false" aria-controls="extended-nav-section-five"> <span onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'NAV-HEADING']);">Exclusions</span> </button> <ul id="extended-nav-section-five" class="usa-nav-submenu"> <li><a href="/exclusions/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'LEIE-OVERVIEW']);">Exclusions Overview</a></li> <li><a href="https://exclusions.oig.hhs.gov" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'LEIE-SEARCH']);">Online Searchable Database</a></li> <li><a href="/exclusions/exclusions_list.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'LEIE-DOWNLOAD']);">LEIE Downloadable Databases</a></li> <li><a href="/exclusions/supplements.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'LEIE-SUPPLEMENTS']);">Monthly Supplement Downloads</a></li> <li><a href="/exclusions/tips.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'QUICK-TIPS']);">Quick Tips</a></li> <li><a href="/exclusions/waivers.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'WAIVERS']);">Waivers</a></li> <li><a href="/exclusions/background.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'BACKGROUND']);">Background Information</a></li> <li><a href="/exclusions/reinstatement.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'REINSTATEMENT']);">Applying for Reinstatement</a></li> <li><a href="/contact-us/index.asp#exclusions" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'CONTACT']);">Contact the Exclusions Program</a></li> <li><a href="/faqs/exclusions-faq.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'FAQ']);">Frequently Asked Questions</a></li> <li><a href="/exclusions/advisories.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'SPECIAL-ADVISORY']);">Special Advisory Bulletin and Other Guidance</a></li> <li><a href="/exclusions/authorities.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'LEIE-AUTHORITIES']);">Exclusion Authorities</a></li> <li><a href="/exclusions/partners.asp" onclick="_sz.push(['event', 'MAIN_NAV-LEIE', 'CLICK', 'PARTNERS']);">Working with Federal and State Partners</a></li> </ul></li> <li><button class="usa-accordion-button usa-nav-link" aria-expanded="false" aria-controls="extended-nav-section-six"> <span onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'NAV-HEADING']);">Newsroom</span> </button> <ul id="extended-nav-section-six" class="usa-nav-submenu"> <li><a href="/newsroom/" onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'NEWS-OVERVIEW']);">Newsroom Overview</a></li> <li><a href="/newsroom/whats-new/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'WHATS-NEW']);">What's New</a></li> <li><a href="/newsroom/news-releases/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'RELEASES-ARTICLES']);">News Releases & Articles</a></li> <li><a href="/newsroom/media-materials/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'MEDIA-MATERIALS']);">Media Materials</a></li> <li><a href="/newsroom/testimony-and-speeches/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'TESTIMONY']);">Testimony</a></li> <li><a href="/newsroom/speeches/" onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'SPEECHES']);">Speeches</a></li> <li><a href="/newsroom/video/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'VIDEOS']);">Videos</a></li> <li><a href="/newsroom/podcasts/index.asp" onclick="_sz.push(['event', 'MAIN_NAV-NEWSROOM', 'CLICK', 'PODCASTS']);">Podcasts</a></li> </ul></li> <li><button class="usa-accordion-button usa-nav-link" aria-expanded="false" aria-controls="extended-nav-section-seven"> <span onclick="_sz.push(['event', 'MAIN_NAV-CAREERS', 'CLICK', 'NAV-HEADING']);">Careers</span> </button> <ul id="extended-nav-section-seven" class="usa-nav-submenu"> <li><a href="/careers/" onclick="_sz.push(['event', 'MAIN_NAV-CAREERS', 'CLICK', 'CAREERS-OVERVIEW']);">Careers Overview</a></li> <li><a href="/careers/internship-opportunities/" onclick="_sz.push(['event', 'MAIN_NAV-CAREERS', 'CLICK', 'INTERNSHIPS']);">Internship Opportunities</a></li> </ul></li> <li class="mobile-search"> <a class="usa-nav-link" href="https://search.usa.gov/search?affiliate=hhs_oig"><span>Search</span></a> </li> </ul> <div class="usa-nav-secondary"> <form class="usa-search js-search-form" id="search_form" action="https://search.usa.gov/search" accept-charset="UTF-8" method="get"><input name="utf8" type="hidden" value="✓" /> <div role="search"> <label class="usa-sr-only" for="search-field">Search</label> <input id="search-field" type="search" name="query" autocomplete="on" class="usagov-search-autocomplete"> <input type="hidden" name="affiliate" id="affiliate" value="hhs_oig" /> <button type="submit" name="commit" value="Search"> <span class="usa-search-submit-text">Search</span> </button> </div> </form> <ul class="usa-unstyled-list usa-nav-secondary-links"> <li>   <a href="/fraud/report-fraud/index.asp" class="report-fraud-nav-link" onclick="_sz.push(['event', 'MAIN_NAV-REPORT-FRAUD', 'CLICK', 'NAV-HEADING']);"> Submit a Complaint </a> </li> </ul> </div> </div> </nav> </header> <div class="usa-overlay"></div> <main class="usa-grid usa-section usa-content usa-layout-docs" id="main-content" style="padding-top:20px;"> <aside class="usa-width-one-fourth usa-layout-docs-sidenav"> <nav> <div id="subNav"> <ul class="usa-sidenav-list"> <li><a href="/exclusions/index.asp">Exclusions Program</a></li> <li><a href="https://exclusions.oig.hhs.gov">Online Searchable Database</a></li> <li><a href="/exclusions/exclusions_list.asp">LEIE Downloadable Databases</a></li> <li><a href="/exclusions/supplements.asp">Monthly Supplement Downloads</a></li> <li><a href="/exclusions/tips.asp">Quick Tips</a></li> <li><a href="/exclusions/waivers.asp">Waivers</a></li> <li><a href="/exclusions/background.asp">Background Information</a></li> <li><a href="/exclusions/reinstatement.asp">Applying for Reinstatement</a></li> <li><a href="/contact-us/index.asp#exclusions">Contact the Exclusions Program</a></li> <li> <a href="/faqs/exclusions-faq.asp">Frequently Asked Questions</a></li> <li> <a href="/exclusions/advisories.asp">Special Advisory Bulletin and Other Guidance</a></li> <li><a href="/exclusions/authorities.asp">Exclusion Authorities</a></li> <li><a href="/exclusions/partners.asp">Working with Federal and State Partners</a></li> </ul> </div> </nav> </aside> <div class="usa-width-three-fourths usa-layout-docs-main_content"> <h1>Exclusion Authorities</h1> <h2 class="line">Scope</h2> <table cellpadding="2" cellspacing="0" border="0" class="generic-table"> <tr> <colgroup> <col style="width:120px"> <col style="width:120px"> <col style="width:auto"> </colgroup> <th scope="col">Social Security Act</th> <th scope="col">42 USC §</th> <th scope="col">Amendment</th> </tr><tr> <td>1128</td> <td>1320a-7</td> <td>Scope of exclusions imposed by OIG expanded from Medicare and State health care programs to all Federal health care programs, as defined in section 1128B(f)(1).</td> </tr></table> <h2 class="line">Mandatory Exclusions</h2> <table cellpadding="2" cellspacing="0" border="0" class="generic-table"> <tr> <colgroup> <col style="width:120px"> <col style="width:120px"> <col style="width:auto"> </colgroup> <th scope="col">Social Security Act</th> <th scope="col">42 USC §</th> <th scope="col">Amendment</th> </tr><tr> <td>1128(a)(1)</td> <td>1320a-7(a)(1)</td> <td>Conviction of program-related crimes. Minimum Period: 5 years</td> </tr><tr> <td>1128(a)(2)</td> <td>1320a-7(a)(2)</td> <td>Conviction relating to patient abuse or neglect. Minimum Period: 5 years</td> </tr><tr> <td>1128(a)(3)</td> <td>1320a-7(a)(3)</td> <td>Felony conviction relating to health care fraud. Minimum Period: 5 years</td> </tr><tr> <td>1128(a)(4)</td> <td>1320a-7(a)(4)</td> <td>Felony conviction relating to controlled substance. Minimum Period: 5 years</td> </tr><tr> <td>1128(c)(3)(G)(i)</td> <td>1320a-7(c)(3)(G)(i)</td> <td>Conviction of second mandatory exclusion offense. Minimum Period: 10 years</td> </tr><tr> <td>1128(c)(3)(G)(ii)</td> <td>1320a-7(c)(3)(G)(ii)</td> <td>Conviction of third or more mandatory exclusion offenses. Permanent Exclusion</td> </tr></table> <h2 class="line">Permissive Exclusions</h2> <table cellpadding="2" cellspacing="0" border="0" class="generic-table"> <tr> <colgroup> <col style="width:120px; border-right:1px solid #e7e7e7"> <col style="width:120px"> <col style="width:auto"> </colgroup> <th scope="col">Social Security Act</th> <th scope="col">42 USC §</th> <th scope="col">Amendment</th> </tr><tr> <td>1128(b)(1)(A)</td> <td>1320a-7(b)(1)(A)</td> <td>Misdemeanor conviction relating to health care fraud. Baseline Period: 3 years</td> </tr><tr> <td>1128(b)(1)(B)</td> <td>1320a-7(b)(1)(B)</td> <td>Conviction relating to fraud in non-health care programs. Baseline Period: 3 years</td> </tr><tr> <td>1128(b)(2)</td> <td>1320a-7(b)(2)</td> <td>Conviction relating to obstruction of an investigation or audit. Baseline Period: 3 years</td> </tr><tr> <td>1128(b)(3)</td> <td>1320a-7(b)(3)</td> <td>Misdemeanor conviction relating to controlled substance. Baseline Period: 3 years</td> </tr><tr> <td>1128(b)(4)</td> <td>1320a-7(b)(4)</td> <td>License revocation, suspension, or surrender. Minimum Period: Period imposed by the state licensing authority.</td> </tr><tr> <td>1128(b)(5)</td> <td>1320a-7(b)(5)</td> <td>Exclusion or suspension under federal or state health care program. Minimum Period: No less than the period imposed by federal or state health care program.</td> </tr><tr> <td>1128(b)(6)</td> <td>1320a-7(b)(6)</td> <td>Claims for excessive charges, unnecessary services or services which fail to meet professionally recognized standards of health care, or failure of an HMO to furnish medically necessary services. Minimum Period: 1 year</td> </tr><tr> <td>1128(b)(7)</td> <td>1320a-7(b)(7)</td> <td>Fraud, kickbacks, and other prohibited activities. Minimum Period: None</td> </tr><tr> <td>1128(b)(8)</td> <td>1320a-7(b)(8)</td> <td>Entities controlled by a sanctioned individual. Minimum Period: Same as length of individual's exclusion.</td> </tr><tr> <td>1128(b)(8)(A)</td> <td>1320a-7(b)(8)(A)</td> <td>Entities controlled by a family or household member of an excluded individual and where there has been a transfer of ownership/control. Minimum Period: Same as length of individual's exclusion.</td> </tr><tr> <td>1128(b)(9), (10), and (11)</td> <td>1320a-7(b)(9), (10), and (11)</td> <td>Failure to disclose required information, supply requested information on subcontractors and suppliers; or supply payment information. Minimum Period: None</td> </tr><tr> <td>1128(b)(12)</td> <td>1320a-7(b)(12)</td> <td>Failure to grant immediate access. Minimum Period: None</td> </tr><tr> <td>1128(b)(13)</td> <td>1320a-7(b)(13)</td> <td>Failure to take corrective action. Minimum Period: None</td> </tr><tr> <td>1128(b)(14)</td> <td>1320a-7(b)(14)</td> <td>Default on health education loan or scholarship obligations. Minimum Period: Until default or obligation has been resolved.</td> </tr><tr> <td>1128(b)(15)</td> <td>1320a-7(b)(15)</td> <td>Individuals controlling a sanctioned entity. Minimum Period: Same as length of entity's exclusion.</td> </tr><tr> <td>1128(b)(16)</td> <td>1320a-7(b)(16)</td> <td>Making false statement or misrepresentations of material fact. Minimum period: None.</td> </tr> <tr> <td>1156</td> <td>1320c-5</td> <td>Failure to meet statutory obligations of practitioners and providers to provide medically necessary services meeting professionally recognized standards of health care (Quality Improvement Organization (QIO) findings). Minimum Period: 1 year</td> </tr> </table> <p style="margin-top:20px;"><strong>Note:</strong> except those imposed under section 1128(b)(7) (42 USC 1320a-7b(b)(7)), and those imposed on rural physicians under section 1156 (42 USC 1320C-5), all exclusions are effective prior to a hearing.</p> </div> </main> <footer class="usa-footer usa-footer-big" role="contentinfo"> <div class="usa-grid usa-footer-return-to-top"> <a href="#">Return to top</a> </div> <div class="usa-footer-primary-section"> <div class="usa-grid"> <nav class="usa-footer-nav usa-width-two-thirds"> <ul class="usa-unstyled-list usa-width-one-fourth usa-footer-primary-content"> <li class="usa-footer-primary-link"> <h4>Related Information</h4> </li> <li><a class="usa-footer-secondary-link" href="/about-oig/contact-us/">Contact Us</a></li> <li><a class="usa-footer-secondary-link" href="https://oig.hhs.gov/oig-policies/">OIG Policies</a></li> <li><a class="usa-footer-secondary-link" href="/faqs/">FAQs</a></li> <li><a class="usa-footer-secondary-link" href="https://www.npdb.hrsa.gov/" target="_blank">NPDB</a></li> <li><a class="usa-footer-secondary-link" href="https://www.hhs.gov" target="_blank">HHS.gov</a></li> <li><a class="usa-footer-secondary-link" href="https://www.ignet.gov/" target="_blank">IGnet</a></li> <li><a class="usa-footer-secondary-link" href="https://www.usa.gov/" target="_blank">USA.gov</a> <li><a class="usa-footer-secondary-link" href="/foia/">FOIA</a></li> <li><a class="usa-footer-secondary-link usa-external_link" href="https://get.adobe.com/reader/">Download Reader</a></li> </ul> <ul class="usa-unstyled-list usa-width-one-fourth usa-footer-primary-content"> <li class="usa-footer-primary-link"> <h4>Publications</h4> </li> <li><a class="usa-footer-secondary-link" href="/about-oig/strategic-plan/">Strategic Plan</a></li> <li><a class="usa-footer-secondary-link" href="/about-oig/oig-budget/">Budget</a></li> <li><a class="usa-footer-secondary-link" href="/reports/all/?report-type=TMC&hhs-agency=#results">Top Management & Performance Challenges</a></li> <li><a class="usa-footer-secondary-link" href="/reports-and-publications/workplan/index.asp">Work Plan</a></li> <li><a class="usa-footer-secondary-link" href="/reports/all/?report-type=SAR#results">Semiannual Reports to Congress</a></li> <li><a class="usa-footer-secondary-link" href="/reports/all/?report-type=Top+Unimp.+Recs&hhs-agency=#results">Unimplemented Recommendations</a></li> </ul> </nav> <div class="usa-sign_up-block usa-width-one-third"> <a class="usa-button usa-button-small" href="https://cloud.connect.hhs.gov/OIG">Subscribe to Our Newsletter</a> </div> </div> </div> <div class="usa-footer-secondary_section usa-footer-big-secondary-section"> <div class="usa-grid"> <div class="usa-footer-logo usa-width-one-half"> <img class="usa-footer-big-logo-img" src="/uswds/img/seal-bw-clear.png" alt=""> <h3 class="usa-footer-big-logo-heading">HHS Office of Inspector General</h3> </div> <div class="usa-footer-contact-links usa-width-one-half"> <a class="usa-link-instagram" href="https://instagram.com/oigathhs/"> <span>Instagram</span> </a> <a class="usa-link-facebook" href="https://www.facebook.com/OIGatHHS/"> <span>Facebook</span> </a> <a class="usa-link-twitter" href="https://twitter.com/OIGatHHS/"> <span>Twitter</span> </a> <a class="usa-link-youtube" href="https://www.youtube.com/user/OIGatHHS"> <span>YouTube</span> </a> <a class="usa-link-linkedin" href="https://www.linkedin.com/company/hhs-office-of-the-inspector-general"> <span>LinkedIn</span> </a> <p><a href="https://oig.hhs.gov/about-oig/contact-us/social-media-directory/">HHS-OIG Social Media Directory</a></p> <address> <h3 class="usa-footer-contact-heading">330 Independence Avenue, SW<br />Washington, DC 20201 </h3> </address> </div> </div> </div> </footer> <script src="/uswds/js/uswds.min.js"></script> <script> //<![CDATA[ var usasearch_config = { siteHandle:"hhs_oig" }; var script = document.createElement("script"); script.type = "text/javascript"; script.src = "//search.usa.gov/javascripts/remote.loader.js"; document.getElementsByTagName("head")[0].appendChild(script); //]]> </script> <script> // Find the element with the specified class const element = document.querySelector('aside.usa-layout-docs-sidenav div.usa-width-one-fourth.related-content-box'); // Replace the inner HTML of the element with new HTML if (element) { element.innerHTML = 'Copies can also be obtained by contacting the <a href="mailto:Public.Affairs@oig.hhs.gov">Office of Public Affairs</a>.'; } </script> <script async src="https://siteimproveanalytics.com/js/siteanalyze_6283531.js"></script> <script async src="https://touchpoints.app.cloud.gov/touchpoints/a2a33ea8.js"></script> </body> </html>