Page:United States Statutes at Large Volume 101 Part 1.djvu/711

 PUBLIC LAW 100-93—AUG. 18, 1987 ,:

101 STAT. 681

related to the delivery of an item or service under title XVIII or under any State health care program.

42 USC 1395.

"(2) CONVICTION RELATING TO PATIENT ABUSE.—Any individual

or entity that has been convicted, under Federal or State law, of r; a criminal offense relating to neglect or abuse of patients in connection with the delivery of a health care item or service. "(b) PERMISSIVE EXCLUSION.—The Secretary may exclude the following individuals and entities from participation in any program under title XVIII and may direct that the following individuals and entities be excluded from participation in any State health care program: "(1) CONVICTION RELATING TO F R A U D. — Any

{ j f

individual

or

entity that has been convicted, under Federal or State law, in connection with the delivery of a health care item or service or with respect to any a c t or omission in a program operated by or financed in whole or in part by any Federal, State, or local government agency, of a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct. "(2) CONVICTION RELATING TO OBSTRUCTION OF A N INVESTIGA-

.v>«^r.;; • nW;Kr >8in

TiON.—Any individual or e n t i t y that has been convicted, under Federal or State law, in connection with the interference with or obstruction of any investigation into any criminal offense described in paragraph (1) or in subsection (a). "(3) CONVICTION RELATING TO CONTROLLED SUBSTANCE.—Any

individual or entity that has been convicted, under Federal or State law, of a criminal offense relating to the unlawful m a n u facture, distribution, prescription, or dispensing of a controlled substance.

Drugs and drug

abuse. .„:(*f:i.;

i.i

"(4) L I C E N S E REVOCATION OR SUSPENSION.—Any individual or

entity— "(A) whose license to provide health care has been re; X voked or suspended by any State licensing authority, or who otherwise lost such a license, for reasons bearing on -.- 3t h e individual's or entity's professional competence, profesgi \ sional performance, or financial integrity, or fj. "(B) w h o s u r r e n d e r e d such a license while a formal disciplinary proceeding was pending before such a n authority .'0A and the proceeding concerned the individual's or entity's ii i; professional competence, professional performance, or financial integrity. "(5) EXCLUSION OR SUSPENSION UNDER FEDERAL OR STATE HEALTH CARE PROGRAM.—Any individual or e n t i t y which has

been suspended or excluded from participation, or otherwise sanctioned, under— "(A) any Federal program, including programs of the m bD e part m e n t of Defense or the Veterans ' Administration, girll involving the provision of health care, or "(B) a State health care program, for reasons bearing on the individual's or entity's professional competence, professional performance, or financial integrity. "(6) CLAIMS FOR EXCESSIVE CHARGES OR UNNECESSARY SERVICES

AND FAILURE OF CERTAIN ORGANIZATIONS TO FURNISH MEDICALLY NECESSARY SERVICES.—Any individual or entity that the Secretary determines— >,;•; "(A) has submitted or caused to be submitted bills or requests for payment (where such bills or requests a r e

.u\ ,0.'"*'7"' ' "^' "= "' •

?•. ' '.*'. •

s-:v q.^^i

�