[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: 42CFR1001.1801]



[Page 1163]

 

                         TITLE 42--PUBLIC HEALTH

 

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

 

PART 1001_PROGRAM INTEGRITY_MEDICARE AND STATE HEALTH CARE PROGRAMS--

 

                Subpart D_Waivers and Effect of Exclusion

 

Sec.  1001.1801  Waivers of exclusions.





    (a) The OIG has the authority to grant or deny a request from a 

State health care program that an exclusion from that program be waived 

with respect to an individual or entity, except that no waiver may be 

granted with respect to an exclusion under Sec.  1001.101(b). The 

request must be in writing and from an individual directly responsible 

for administering the State health care program.

    (b) With respect to exclusions under Sec.  1001.101(a), a request 

from a State health care program for a waiver of the exclusion will only 

be considered if the individual or entity is the sole community 

physician or the sole source of essential specialized services in a 

community.

    (c) With respect to exclusions imposed under subpart C of this part, 

a request for waiver will only be granted if the OIG determines that 

imposition of the exclusion would not be in the public interest.

    (d) If the basis for the waiver ceases to exist, the waiver will be 

rescinded, and the individual or entity will be excluded for the period 

remaining on the exclusion, measured from the time the exclusion would 

have been imposed if the waiver had not been granted.

    (e) In the event a waiver is granted, it is applicable only to the 

program(s) for which waiver is requested.

    (f) The decision to grant, deny or rescind a request for a waiver is 

not subject to administrative or judicial review.

    (g) The Inspector General may waive the exclusion of an individual 

or entity from participation in the Medicare program in conjunction with 

granting a waiver requested by a State health care program. If a State 

program waiver is rescinded, the derivative waiver of the exclusion from 

Medicare is automatically rescinded.