The question requests information about final adverse legal actions imposed against the applicant.
All applicable final adverse legal actions must be reported, regardless of whether any records were expunged or any appeals are pending.
NOTE: Providers/Suppliers are no longer required to report 'CMS-Imposed Medicare Revocations' and 'Medicare Payment Suspension'. Previously reported 'CMS-Imposed Medicare Revocations' and 'Medicare Payment Suspension' information, will not be displayed to Providers/Suppliers in PECOS PI.
A. CONVICTIONS (AS DEFINED IN 42 C.F.R. SECTION 1001.2) WITHIN THE PRECEDING 10 YEARS
Any federal or state felony conviction(s) by the provider, supplier, or any owner or managing employee of the provider or supplier.
Any crime, under Federal or State law, which received a sentence of deferred adjudication, adjudication withheld, stay of adjudication, withholding of judgment, or order of deferral - regardless of whether the court dismissed the case upon completion of probation, and regardless of whether the felony was reduced to a misdemeanor.
Any misdemeanor conviction, under federal or state law, related to: (a) the delivery of an item or service under Medicare or a state health care program, or (b) the abuse or neglect of a patient in connection with the delivery of a health care item or service.
Any misdemeanor conviction, under federal or state law, related to the theft, fraud, embezzlement, breach of fiduciary duty, or other financial misconduct in connection with the delivery of a health care item or service.
Any misdemeanor conviction, under federal or state law, related to the interference with or obstruction of any investigation into any criminal offence described in 42C. F.R. section 1001.101 or 1001.201.
Any misdemeanor conviction, under federal or state law, related to the unlawful manufacture, distribution, prescription, or dispensing of a controlled substance.
B. EXCLUSIONS, REVOCATIONS OR SUSPENSIONS
- Any current or past revocation or suspension of medical license.
- Any current or past revocation or suspension of accreditation.
- Any current or past suspension or exclusion imposed by the U.S. Department of Health and Human Service's Office of Inspector General (OIG).
- Any current or past debarment from participation in any Federal Executive Branch procurement or non-procurement program.
- Any other current or past Federal Sanctions.
- Any Medicaid exclusion, revocation, enrollment suspension or termination of any billing number.