[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: 42CFR1001.1101]



[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.  1001.1101  Failure to disclose certain information.



    (a) Circumstance for exclusion. The OIG may exclude any entity that 

did not fully and accurately, or completely, make disclosures as 

required by section 1124, 1124A or 1126 of the Act, and by part 455, 

subpart B and part 420, subpart C of this title.

    (b) Length of exclusion. The following factors will be considered in 

determining the length of an exclusion under this section--

    (1) The number of instances where full and accurate, or complete, 

disclosure was not made;

    (2) The significance of the undisclosed information;

    (3) Whether the individual or entity has a documented history of 

criminal, civil or administrative wrongdoing (The lack of any prior 

record is to be considered neutral);

    (4) Any other facts that bear on the nature or seriousness of the 

conduct;

    (5) The availability of alternative sources of the type of health 

care services provided by the entity; and

    (6) The extent to which the entity knew that the disclosures made 

were not full or accurate.



[57 FR 3330, Jan. 29, 1992, as amended at 63 FR 46689, Sept. 2, 1998]