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42 CFR--PART 423

View Printed Federal Register page 84 FR 15840 in PDF format.

Amendment(s) published April 16, 2019, in 84 FR 15840

Effective Dates: Jan. 1, 2020

27. In 423.100, in the definition of “Preclusion list”, revise paragraphs (1)(i), (2)(i), (2)(ii)(C) and add paragraph (3) to read as follows:

§423.100   Definitions.

*   *   *   *   *

Preclusion list *  *  *

(1) *  *  *

(i) The prescriber is currently revoked from Medicare for a reason other than that stated in §424.535(a)(3) of this chapter.

*   *   *   *   *

(2) *  *  *

(i) The prescriber has engaged in behavior, other than that described in §424.535(a)(3) of this chapter, for which CMS could have revoked the individual to the extent applicable had he or she been enrolled in Medicare.

(ii) *  *  *

(C) Any other evidence that CMS deems relevant to its determination; or

(3) The prescriber, regardless of whether he or she is or was enrolled in Medicare, has been convicted of a felony under Federal or State law within the previous 10 years that CMS deems detrimental to the best interests of the Medicare program. Factors that CMS considers in making such a determination under this paragraph are as follows:

(i) The severity of the offense.

(ii) When the offense occurred.

(iii) Any other information that CMS deems relevant to its determination.

*   *   *   *   *

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