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1128A(a)(1)(A), (B)
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1320a-7a(a)(1)(A), (B)
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1003.102(a)(1), (2)
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False claims
|
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1128A(a)(1)(C)
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1320a-7a(a)(1)(C)
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1003.102(a)(4)
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Claims submitted with a false certification of physician license
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1128A(a)(1)(D)
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1320a-7a(a)(1)(D)
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1003.102(a)(2), (3)
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Claims presented by excluded party
|
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1128A(a)(2)
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1320a-7a(a)(2)
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1003.102(b)(1)(i)
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Assignment agreement, participating physician or supplier agreement violation
|
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1128A(a)(3)
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1320a-7a(a)(3)
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1003.102(b)(4)
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A participating physician or supplier that knowingly gives false or misleading information that could reasonably be expected to influence the decision when to discharge an individual from the hospital
|
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1128A(a)(4)
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1320a-7a(a)(4)
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1003.102(b)(12)
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Excluded party retaining ownership or control interest in participating entity
|
|
1128A(a)(5)
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1320a-7a(a)(5)
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1003.102(b)(13)
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Remuneration offered to induce program beneficiaries to use particular providers, practitioners, or suppliers
|
|
1128A(a)(6)
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1320a-7a(a)(6)
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1003.102(a)(2)
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Employing or contracting with an excluded individual
|
|
1128A(a)(1)(E)
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1320a-7a(a)(1)(E)
|
1003.102(a)(6)
|
Pattern of claims for medically unnecessary services/supplies
|
|
1128A(a)(7)
|
1320a-7a(a)(7)
|
1003.102(b)(11)
|
Improper remuneration to induce referrals
|
|
1128A(a)(8)
|
1320a-7a(a)(8)
|
|
Ordering or prescribing while excluded
|
|
1128A(a)(9)
|
1320a-7a(a)(9)
|
|
Making false statements, omissions, misrepresentations in an enrollment application
|
|
1128A(a)(10)
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1320a-7a(a)(10)
|
|
Known retention of an overpayment
|
|
1128A(a)[11](8)
|
1320a-7a(a)[11](8)
|
|
Making or using a false record or statement that is material to a false or fraudulent claim
|
|
1128A(a)[12](9)
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1320a-7a(a)[12](9)
|
|
Failure to grant timely access to OIG for audits, investigations, evaluations, or other statutory functions of OIG
|
|
1140(b)
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1320b-10(b)
|
|
Misuse of Departmental symbols/emblems
|
|
1834(a)(18)(B) and 1842(j)(2)
|
1395m(a)(18)(B) and 1395u(j)(2)
|
402.1(c)(5)
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Any nonparticipating durable medical equipment supplier that knowingly and willfully fails to make a refund to Medicare beneficiaries for a covered service for which payment is precluded due to an unsolicited telephone contact from the supplier
|
|
1867(d)(1)
|
1395dd(d)(1)
|
|
Dumping by hospital or responsible physician of patients needing emergency medical care
|
|
1876(i)(6)(A)(v), 1903(m)(5)(A)(iv), and 1857(g)(1)(E)
|
1395mm(i)(6)(A)(v), 1396b(m)(5)(A)(iv), and 1395w-27(g)(1)(E)\
|
|
False or misrepresenting Medicare+Choice/HMO competitive medical plan information to Secretary, and individual, or other entity
|
|
1877(g)(3)
|
1395nn(g)(3)
|
|
Presenting claims for designated health services furnished while in a prohibited financial relationship
|
|
1877(g)(4)
|
1395nn(g)(4)
|
|
Circumventing physician financial relationship restrictions
|
|
1927(b)(3)(B)
|
1396r-8(b)(3)(B)
|
|
False information on a drug manufacturer survey from manufacturer, wholesaler, or seller
|
|
1927(b)(3)(C)
|
1396r-8(b)(3)(C)
|
414.806
|
Provision of untimely or false information by a drug manufacturer with rebate agreement
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