[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR1001.1051]



[Page 1158]

 

                         TITLE 42--PUBLIC HEALTH

 

      GENERAL--HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

PART 1001_PROGRAM INTEGRITY_MEDICARE AND STATE HEALTH CARE PROGRAMS--

 

                     Subpart C_Permissive Exclusions

 

Sec.  1001.1051  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 Sec. Sec.  

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 with which the individual has the prohibited 

relationship.

    (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 Sec.  

1001.3001.



[63 FR 46689, Sept. 2, 1998]