|
1128A(a)(1)(A)
|
1320a-7a(a)(1)(A)
|
1003.200(a)(1)
|
Claims for items or services not provided as claimed
|
|
1128A(a)(1)(B)
|
1320a-7a(a)(1)(B)
|
1003.200(a)(2)
|
False or fraudulent claims
|
|
1128A(a)(1)(C)
|
1320a-7a(a)(1)(C)
|
1003.200(a)(4)
|
Claims for physician services not furnished or supervised by a licensed physician
|
|
1128A(a)(1)(D)
|
1320a-7a(a)(1)(D)
|
1003.200(a)(3)
|
Claims for items or services furnished by an excluded person
|
|
1128A(a)(1)(E)
|
1320a-7a(a)(1)(E)
|
1003.200(a)(5)
|
Pattern of claims for medical or other items or services not medically necessary
|
|
1128A(a)(2)
|
1320a-7a(a)(2)
|
1003.200(b)(1)
|
Assignment agreement, participating physician or supplier agreement violation
|
|
1128A(a)(4)
|
1320a-7a(a)(4)
|
1003.200(b)(3)
|
Excluded party retaining ownership or control interest in participating entity
|
|
1128A(a)(5)
|
1320a-7a(a)(5)
|
1003.1
|
Remuneration offered to induce program beneficiaries to use particular providers, practitioners, or suppliers
|
|
1128A(a)(6)
|
1320a-7a(a)(6)
|
1003.200(b)(4)
|
Employing, arranging or contracting with an excluded individual
|
|
1128A(a)(7)
|
1320a-7a(a)(7)
|
1003.3
|
Improper remuneration to induce referrals
|
|
1128A(a)(8)
|
1320a-7a(a)(8)
|
1003.200(b)(6)
|
Ordering or prescribing while excluded
|
|
1128A(a)(9)
|
1320a-7a(a)(9)
|
1003.200(b)(7)
|
Making false statements, omissions, misrepresentations in an enrollment application
|
|
1128A(a)(10)
|
1320a-7a(a)(10)
|
1003.200(b)(8)
|
Known retention of an overpayment
|
|
1128A(a)[11](8)
|
1320a-7a(a)[11](8)
|
1003.200(b)(9)
|
Making or using a false record or statement that is material to a false or fraudulent claim
|
|
1128A(a)[12](9)
|
1320a-7a(a)[12](9)
|
1003.200(b)(10)
|
Failure to grant timely access to OIG for audits, investigations, evaluations, or other statutory functions of OIG
|
|
1140(b)
|
1320b-10(b)
|
1003.6
|
Misuse of Departmental symbols/emblems
|
|
1867(d)(1)
|
1395dd(d)(1)
|
1003.5
|
Dumping by hospital or responsible physician of patients needing emergency medical care
|
|
1877(g)(3)
|
1395nn(g)(3)
|
1003.3
|
Presenting claims for designated health services furnished while in a prohibited financial relationship
|
|
1877(g)(4)
|
1395nn(g)(4)
|
1003.3
|
Circumventing physician financial relationship restrictions
|
|
1927(b)(3)(B)
|
1396r-8(b)(3)(B)
|
1003.1
|
False information on a drug manufacturer survey from manufacturer, wholesaler, or seller
|
|
1927(b)(3)(C)
|
1396r-8(b)(3)(C)
|
1003.1
|
Provision of untimely or false information by a drug manufacturer with rebate agreement
|
