Health Care Programs: Fraud and Abuse; Revisions to the PRO Sanctions Process
other · US Department of Health and Human Services · Rule · Published 1995-12-12 · 60 FR 63634
Document
Document number
95-30130
Federal Register citation
60 FR 63634
CFR reference
42 CFR 1004
Type
Rule
Action
Final rule.
Category
other
Sub-agency
US Department of Health and Human Services
Publication date
1995-12-12
Abstract
This final rule revises and updates the procedures governing the imposition and adjudication of program sanctions predicated on recommendations of State Utilization and Quality Control Peer Review Organizations (PROs). These changes are being made as a result of statutory revisions designed to address health care fraud and abuse issues and the OIG sanctions process. In addition, this final rule sets forth new appeal and reinstatement procedures for practitioners and other persons excluded by the OIG based on a PRO recommendation.