CFR

SUBPART J—Administrative Sanctions Imposed Against Health Care Providers (§890.1001 to §890.1072)

• 890.1001—Scope and purpose.
• 890.1002—Use of terminology.
• 890.1003—Definitions.
• 890.1004—Bases for mandatory debarments.
• 890.1005—Time limits for OPM to initiate mandatory debarments.
• 890.1006—Notice of proposed mandatory debarment.
• 890.1007—Minimum length of mandatory debarments.
• 890.1008—Mandatory debarment for longer than the minimum length.
• 890.1009—Contesting proposed mandatory debarments.
• 890.1010—Debarring official's decision of contest.
• 890.1011—Bases for permissive debarments.
• 890.1012—Time limits for OPM to initiate permissive debarments.
• 890.1013—Deciding whether to propose a permissive debarment.
• 890.1014—Notice of proposed permissive debarment.
• 890.1015—Minimum and maximum length of permissive debarments.
• 890.1016—Aggravating and mitigating factors used to determine the length of permissive debarments.
• 890.1017—Determining length of debarment based on revocation or suspension of a provider's professional licensure.
• 890.1018—Determining length of debarment for an entity owned or controlled by a sanctioned provider.
• 890.1019—Determining length of debarment based on ownership or control of a sanctioned entity.
• 890.1020—Determining length of debarment based on false, wrongful, or deceptive claims.
• 890.1021—Determining length of debarment based on failure to furnish information needed to resolve claims.
• 890.1022—Contesting proposed permissive debarments.
• 890.1023—Information considered in deciding a contest.
• 890.1024—Standard and burden of proof for deciding contests.
• 890.1025—Cases where additional fact-finding is not required.
• 890.1026—Procedures if a fact-finding proceeding is not required.
• 890.1027—Cases where an additional fact-finding proceeding is required.
• 890.1028—Conducting a fact-finding proceeding.
• 890.1029—Deciding a contest after a fact-finding proceeding.
• 890.1030—Effect of a suspension.
• 890.1031—Grounds for suspension.
• 890.1032—Length of suspension.
• 890.1033—Notice of suspension.
• 890.1034—Counting a period of suspension as part of a subsequent debarment.
• 890.1035—Provider contests of suspensions.
• 890.1036—Information considered in deciding a contest.
• 890.1037—Cases where additional fact-finding is not required.
• 890.1038—Deciding a contest without additional fact-finding.
• 890.1039—Cases where additional fact-finding is required.
• 890.1040—Conducting a fact-finding proceeding.
• 890.1041—Deciding a contest after a fact-finding proceeding.
• 890.1042—Effective dates of debarments.
• 890.1043—Effect of debarment on a provider.
• 890.1044—Entities notified of OPM-issued debarments and suspensions.
• 890.1045—Informing persons covered by FEHBP about debarment or suspension of their provider.
• 890.1046—Effect of debarment or suspension on payments for services furnished in emergency situations.
• 890.1047—Special rules for institutional providers.
• 890.1048—Waiver of debarment for a provider that is the sole source of health care services in a community.
• 890.1049—Claims for non-emergency items or services furnished by a debarred or suspended provider.
• 890.1050—Exception to a provider's debarment for an individual enrollee.
• 890.1051—Applying for reinstatement when period of debarment expires.
• 890.1052—Reinstatements without application.
• 890.1053—Table of procedures and effective dates for reinstatements.
• 890.1054—Agencies and entities to be notified of reinstatements.
• 890.1055—Contesting a denial of reinstatement.
• 890.1060—Purpose and scope of civil monetary penalties and assessments.
• 890.1061—Bases for penalties and assessments.
• 890.1062—Deciding whether to impose penalties and assessments.
• 890.1063—Maximum amounts of penalties and assessments.
• 890.1064—Determining the amounts of penalties and assessments to be imposed on a provider.
• 890.1065—Deciding whether to suspend or debar a provider in a case that also involves penalties and assessments.
• 890.1066—Notice of proposed penalties and assessments.
• 890.1067—Provider contests of proposed penalties and assessments.
• 890.1068—Effect of not contesting proposed penalties and assessments.
• 890.1069—Information the debarring official must consider in deciding a provider's contest of proposed penalties and assessments.
• 890.1070—Deciding contests of proposed penalties and assessments.
• 890.1071—Further appeal rights after final decision to impose penalties and assessments.
• 890.1072—Collecting penalties and assessments.

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