Title 5

PART 890 SUBPART J

Subpart J - Administrative Sanctions Imposed Against Health Care Providers Authority:5 U.S.C. 8902a. Source:68 FR 5475, Feb. 3, 2003, unless otherwise noted.

Authority: 5 U.S.C. 8913; Sec. 890.301 also issued under sec. 311 of Pub. L. 111-03, 123 Stat. 64; Sec. 890.111 also issued under section 1622(b) of Pub. L. 104-106, 110 Stat. 521; Sec. 890.112 also issued under section 1 of Pub. L. 110-279, 122 Stat. 2604; 5 U.S.C. 8913; Sec. 890.803 also issued under 50 U.S.C. 403p, 22 U.S.C. 4069c and 4069c-1; subpart L also issued under sec. 599C of Pub. L. 101-513, 104 Stat. 2064, as amended; Sec. 890.102 also issued under sections 11202(f), 11232(e), 11246(b) and (c) of Pub. L. 105-33, 111 Stat. 251; and section 721 of Pub. L. 105-261, 112 Stat. 2061; Pub. L. 111-148, as amended by Pub. L. 111-152.
Source: 33 FR 12510, Sept. 4, 1968, unless otherwise noted.

5:2.0.1.1.35.10.161	SUBJGRP 161	General Provisions and Definitions
5:2.0.1.1.35.10.161.1	SECTION 890.1001	890.1001 Scope and purpose.
5:2.0.1.1.35.10.161.2	SECTION 890.1002	890.1002 Use of terminology.
5:2.0.1.1.35.10.161.3	SECTION 890.1003	890.1003 Definitions.
5:2.0.1.1.35.10.162	SUBJGRP 162	Mandatory Debarments
5:2.0.1.1.35.10.162.4	SECTION 890.1004	890.1004 Bases for mandatory debarments.
5:2.0.1.1.35.10.162.5	SECTION 890.1005	890.1005 Time limits for OPM to initiate mandatory debarments.
5:2.0.1.1.35.10.162.6	SECTION 890.1006	890.1006 Notice of proposed mandatory debarment.
5:2.0.1.1.35.10.162.7	SECTION 890.1007	890.1007 Minimum length of mandatory debarments.
5:2.0.1.1.35.10.162.8	SECTION 890.1008	890.1008 Mandatory debarment for longer than the minimum length.
5:2.0.1.1.35.10.162.9	SECTION 890.1009	890.1009 Contesting proposed mandatory debarments.
5:2.0.1.1.35.10.162.10	SECTION 890.1010	890.1010 Debarring official's decision of contest.
5:2.0.1.1.35.10.163	SUBJGRP 163	Permissive Debarments
5:2.0.1.1.35.10.163.11	SECTION 890.1011	890.1011 Bases for permissive debarments.
5:2.0.1.1.35.10.163.12	SECTION 890.1012	890.1012 Time limits for OPM to initiate permissive debarments.
5:2.0.1.1.35.10.163.13	SECTION 890.1013	890.1013 Deciding whether to propose a permissive debarment.
5:2.0.1.1.35.10.163.14	SECTION 890.1014	890.1014 Notice of proposed permissive debarment.
5:2.0.1.1.35.10.163.15	SECTION 890.1015	890.1015 Minimum and maximum length of permissive debarments.
5:2.0.1.1.35.10.163.16	SECTION 890.1016	890.1016 Aggravating and mitigating factors used to determine the length of permissive debarments.
5:2.0.1.1.35.10.163.17	SECTION 890.1017	890.1017 Determining length of debarment based on revocation or suspension of a provider's professional licensure.
5:2.0.1.1.35.10.163.18	SECTION 890.1018	890.1018 Determining length of debarment for an entity owned or controlled by a sanctioned provider.
5:2.0.1.1.35.10.163.19	SECTION 890.1019	890.1019 Determining length of debarment based on ownership or control of a sanctioned entity.
5:2.0.1.1.35.10.163.20	SECTION 890.1020	890.1020 Determining length of debarment based on false, wrongful, or deceptive claims.
5:2.0.1.1.35.10.163.21	SECTION 890.1021	890.1021 Determining length of debarment based on failure to furnish information needed to resolve claims.
5:2.0.1.1.35.10.163.22	SECTION 890.1022	890.1022 Contesting proposed permissive debarments.
5:2.0.1.1.35.10.163.23	SECTION 890.1023	890.1023 Information considered in deciding a contest.
5:2.0.1.1.35.10.163.24	SECTION 890.1024	890.1024 Standard and burden of proof for deciding contests.
5:2.0.1.1.35.10.163.25	SECTION 890.1025	890.1025 Cases where additional fact-finding is not required.
5:2.0.1.1.35.10.163.26	SECTION 890.1026	890.1026 Procedures if a fact-finding proceeding is not required.
5:2.0.1.1.35.10.163.27	SECTION 890.1027	890.1027 Cases where an additional fact-finding proceeding is required.
5:2.0.1.1.35.10.163.28	SECTION 890.1028	890.1028 Conducting a fact-finding proceeding.
5:2.0.1.1.35.10.163.29	SECTION 890.1029	890.1029 Deciding a contest after a fact-finding proceeding.
5:2.0.1.1.35.10.164	SUBJGRP 164	Suspension
5:2.0.1.1.35.10.164.30	SECTION 890.1030	890.1030 Effect of a suspension.
5:2.0.1.1.35.10.164.31	SECTION 890.1031	890.1031 Grounds for suspension.
5:2.0.1.1.35.10.164.32	SECTION 890.1032	890.1032 Length of suspension.
5:2.0.1.1.35.10.164.33	SECTION 890.1033	890.1033 Notice of suspension.
5:2.0.1.1.35.10.164.34	SECTION 890.1034	890.1034 Counting a period of suspension as part of a subsequent debarment.
5:2.0.1.1.35.10.164.35	SECTION 890.1035	890.1035 Provider contests of suspensions.
5:2.0.1.1.35.10.164.36	SECTION 890.1036	890.1036 Information considered in deciding a contest.
5:2.0.1.1.35.10.164.37	SECTION 890.1037	890.1037 Cases where additional fact-finding is not required.
5:2.0.1.1.35.10.164.38	SECTION 890.1038	890.1038 Deciding a contest without additional fact-finding.
5:2.0.1.1.35.10.164.39	SECTION 890.1039	890.1039 Cases where additional fact-finding is required.
5:2.0.1.1.35.10.164.40	SECTION 890.1040	890.1040 Conducting a fact-finding proceeding.
5:2.0.1.1.35.10.164.41	SECTION 890.1041	890.1041 Deciding a contest after a fact-finding proceeding.
5:2.0.1.1.35.10.165	SUBJGRP 165	Effect of Debarment
5:2.0.1.1.35.10.165.42	SECTION 890.1042	890.1042 Effective dates of debarments.
5:2.0.1.1.35.10.165.43	SECTION 890.1043	890.1043 Effect of debarment on a provider.
5:2.0.1.1.35.10.166	SUBJGRP 166	Notifying Outside Parties About Debarment and Suspension Actions
5:2.0.1.1.35.10.166.44	SECTION 890.1044	890.1044 Entities notified of OPM-issued debarments and suspensions.
5:2.0.1.1.35.10.166.45	SECTION 890.1045	890.1045 Informing persons covered by FEHBP about debarment or suspension of their provider.
5:2.0.1.1.35.10.167	SUBJGRP 167	Exceptions to the Effect of Debarments
5:2.0.1.1.35.10.167.46	SECTION 890.1046	890.1046 Effect of debarment or suspension on payments for services furnished in emergency situations.
5:2.0.1.1.35.10.167.47	SECTION 890.1047	890.1047 Special rules for institutional providers.
5:2.0.1.1.35.10.167.48	SECTION 890.1048	890.1048 Waiver of debarment for a provider that is the sole source of health care services in a community.
5:2.0.1.1.35.10.168	SUBJGRP 168	Special Exceptions To Protect Covered Persons
5:2.0.1.1.35.10.168.49	SECTION 890.1049	890.1049 Claims for non-emergency items or services furnished by a debarred or suspended provider.
5:2.0.1.1.35.10.168.50	SECTION 890.1050	890.1050 Exception to a provider's debarment for an individual enrollee.
5:2.0.1.1.35.10.169	SUBJGRP 169	Reinstatement
5:2.0.1.1.35.10.169.51	SECTION 890.1051	890.1051 Applying for reinstatement when period of debarment expires.
5:2.0.1.1.35.10.169.52	SECTION 890.1052	890.1052 Reinstatements without application.
5:2.0.1.1.35.10.169.53	SECTION 890.1053	890.1053 Table of procedures and effective dates for reinstatements.
5:2.0.1.1.35.10.169.54	SECTION 890.1054	890.1054 Agencies and entities to be notified of reinstatements.
5:2.0.1.1.35.10.169.55	SECTION 890.1055	890.1055 Contesting a denial of reinstatement.
5:2.0.1.1.35.10.170	SUBJGRP 170	Civil Monetary Penalties and Financial Assessments
5:2.0.1.1.35.10.170.56	SECTION 890.1060	890.1060 Purpose and scope of civil monetary penalties and assessments.
5:2.0.1.1.35.10.170.57	SECTION 890.1061	890.1061 Bases for penalties and assessments.
5:2.0.1.1.35.10.170.58	SECTION 890.1062	890.1062 Deciding whether to impose penalties and assessments.
5:2.0.1.1.35.10.170.59	SECTION 890.1063	890.1063 Maximum amounts of penalties and assessments.
5:2.0.1.1.35.10.170.60	SECTION 890.1064	890.1064 Determining the amounts of penalties and assessments to be imposed on a provider.
5:2.0.1.1.35.10.170.61	SECTION 890.1065	890.1065 Deciding whether to suspend or debar a provider in a case that also involves penalties and assessments.
5:2.0.1.1.35.10.170.62	SECTION 890.1066	890.1066 Notice of proposed penalties and assessments.
5:2.0.1.1.35.10.170.63	SECTION 890.1067	890.1067 Provider contests of proposed penalties and assessments.
5:2.0.1.1.35.10.170.64	SECTION 890.1068	890.1068 Effect of not contesting proposed penalties and assessments.
5:2.0.1.1.35.10.170.65	SECTION 890.1069	890.1069 Information the debarring official must consider in deciding a provider's contest of proposed penalties and assessments.
5:2.0.1.1.35.10.170.66	SECTION 890.1070	890.1070 Deciding contests of proposed penalties and assessments.
5:2.0.1.1.35.10.170.67	SECTION 890.1071	890.1071 Further appeal rights after final decision to impose penalties and assessments.
5:2.0.1.1.35.10.170.68	SECTION 890.1072	890.1072 Collecting penalties and assessments.