2005 CFR Title 42, Volume 4

Title 42--Public Health CHAPTER V--OFFICE OF INSPECTOR GENERAL--HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 1001--PROGRAM INTEGRITY--MEDICARE AND STATE HEALTH CARE PROGRAMS
	1001.1	Scope and purpose.
	1001.2	Definitions.
	1001.101	Basis for liability.
	1001.102	Length of exclusion.
	1001.201	Conviction relating to program or health care fraud.
	1001.301	Conviction relating to obstruction of an investigation.
	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.
	1001.952	Exceptions.
	1001.1001	Exclusion of entities owned or controlled by a sanctioned person.
	1001.1051	Exclusion of individuals with ownership or control interest in sanctioned entities.
	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.
	1001.1601	Violations of the limitations on physician charges.
	1001.1701	Billing for services of assistant at surgery during cataract operations.
	1001.1801	Waivers of exclusions.
	1001.1901	Scope and effect of exclusion.
	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.
	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	Reversed or vacated decisions.