The length of exclusion from participation in Medicare, Medicaid, and, where applicable, other Federal health care programs, is contingent upon the specific violation of the Medicare statute. A full description of the specific violations identified in the sections of the Act are cross-referenced in the regulatory sections listed in the table in paragraph (a) of this section.
(a) In no event will the period of exclusion exceed 5 years for violation of the following sections of the Act: ------------------------------------------------------------------------
Code of Federal Regulations
Social Security Act paragraph section------------------------------------------------------------------------1833(h)(5)(D) in repeated cases........ Sec. 402.1(c)(1)1833(q)(2)(B) in repeated cases........ Sec. 402.1(c)(3)1834(a)(11)(A)......................... Sec. 402.1(c)(4)1834(a)(18)(B)......................... Sec. 402.1(c)(5)1834(b)(5)(C).......................... Sec. 402.1(c)(6)1834(c)(4)(C).......................... Sec. 402.1(c)(7)1834(h)(3)............................. Sec. 402.1(c)(8)1834(j)(4)............................. Sec. 402.1(c)(10)1834(k)(6)............................. Sec. 402.1(c)(31)1834(l)(6)............................. Sec. 402.1(c)(32)1842(b)(18)(B)......................... Sec. 402.1(c)(11)1842(k)................................ Sec. 402.1(c)(12)1842(l)(3)............................. Sec. 402.1(c)(13)1842(m)(3)............................. Sec. 402.1(c)(14)1842(n)(3)............................. Sec. 402.1(c)(15)1842(p)(3)(B) in repeated cases........ Sec. 402.1(c)(16)1848(g)(1)(B) in repeated cases........ Sec. 402.1(c)(17)1848(g)(3)(B).......................... Sec. 402.1(c)(18)1848(g)(4)(B)(ii) in repeated cases.... Sec. 402.1(c)(19)1879(h)................................ Sec. 402.1(c)(23)------------------------------------------------------------------------
(b) For violation of the following sections, there is no maximum time limit for the period of exclusion. ------------------------------------------------------------------------
Code of Federal Regulations
Social Security Act paragraph section------------------------------------------------------------------------1834(a)(17)(c) for a pattern of Sec. 402.1(e)(2)(i)
contacts.1834(h)(3) for a pattern of contacts... Sec. 402.1(e)(2)(ii)1877(g)(5)............................. Sec. 402.1(c)(22)1882(a)(2)............................. Sec. 402.1(c)(24)1882(p)(8)............................. Sec. 402.1(c)(25)1882(p)(9)(C).......................... Sec. 402.1(c)(26)1882(q)(5)(C).......................... Sec. 402.1(c)(27)1882(r)(6)(A).......................... Sec. 402.1(c)(28)1882(s)(4)............................. Sec. 402.1(c)(29)1882(t)(2)............................. Sec. 402.1(c)(30)------------------------------------------------------------------------
(c) For a person excluded under any of the grounds specified in paragraph (a) of this section, notwithstanding any other requirements in this section, reinstatement occurs--
(1) At the expiration of the period of exclusion, if the exclusion was imposed for a period of 5 years; or
(2) At the expiration of 5 years from the effective date of the exclusion, if the exclusion was imposed for a period of less than 5 years and the initiating agency did not receive the appropriate written request for reinstatement as specified in Sec. 402.300.