Common use of Automatic Suspensions/Mandatory Exclusions Clause in Contracts

Automatic Suspensions/Mandatory Exclusions. DHCS shall automatically suspend Provider under the following circumstances: (1) Upon notice from the Secretary of the United States Department of Health and Human Services that Provider has been excluded from participation in the Medicare or Medicaid programs. No administrative appeal of a suspension on this ground shall be available to Provider. (Welfare and Institutions Code, § 14123 (b)-(c)) (2) If Provider has license(s), certificate(s), or other approval(s) to provide health care services, revoked or suspended by a federal, California, or another state’s licensing, certification, or approval authority; has otherwise lost that/those license(s), certificate(s), or approval(s); or has surrendered that/those license(s), certificate(s), or approval(s) while a disciplinary hearing on that license, certificate, or approval was pending. (Welfare and Institutions Code, § 14043.6.) (3) If Provider is convicted of any felony or any misdemeanor involving fraud, or abuse of the Medi-Cal program or any patient, or otherwise substantially related to the qualifications, functions, or duties of a provider of service. Suspension following conviction is not subject to the proceedings under Welfare and Institutions Code, § 14123(c). However, the director may grant an informal hearing at the request of the provider to determine in the director’s sole discretion if the circumstances surrounding the conviction justify rescinding or otherwise modifying the suspension.

Automatic Suspensions/Mandatory Exclusions. DHCS shall automatically suspend Provider under the following circumstances: (1) Upon notice from the Secretary of the United States Department of Health and Human Services that Provider has been excluded from participation in the Medicare or Medicaid programs. No administrative appeal of a suspension on this ground shall be available to Provider. (Welfare and Institutions Code, § 14123 (b)-(c).) (2) If Provider has license(s), certificate(s), or other approval(s) to provide health care services, revoked or suspended by a federal, California, or another state’s licensing, certification, or approval authority; has otherwise lost that/those license(s), certificate(s), or approval(s); or has surrendered that/those license(s), certificate(s), or approval(s) while a disciplinary hearing on that license, certificate, or approval was pending. (Welfare and Institutions Code, § 14043.6.) (3) If Provider is convicted of any felony or any misdemeanor involving fraud, or abuse of the Medi-Cal program or any patient, or otherwise substantially related to the qualifications, functions, or duties of a provider of service. Suspension following conviction is not subject to the proceedings under Welfare and Institutions Code, § 14123(c). However, the director may grant an informal hearing at the request of the provider to determine in the director’s sole discretion if the circumstances surrounding the conviction justify rescinding or otherwise modifying the suspension.

Automatic Suspensions/Mandatory Exclusions. DHCS shall automatically suspend Provider under the following circumstances: (1) Upon notice from the Secretary of the United States Department of Health and Human Services that Provider has been excluded from participation in the Medicare or Medicaid programs. No administrative appeal of a suspension on this ground shall be available to Provider. (Welfare and Institutions Code, § 14123 (b)-(c).) (2) If Provider has license(s), certificate(s), or other approval(s) to provide health care services, revoked or suspended by a federal, California, or another state’s licensing, certification, or approval authority; has otherwise lost that/those license(s), certificate(s), or approval(s); or has surrendered that/those license(s), certificate(s), or approval(s) while a disciplinary hearing on that license, certificate, or approval was pending. (Welfare and Institutions Code, § 14043.6.) (3) If Provider is convicted of any felony or any misdemeanor involving fraud, or abuse of the Medi-Cal program or any patient, or otherwise substantially related to the qualifications, functions, or duties of a provider of service. Suspension following conviction is not subject to the proceedings under Welfare and Institutions Code, § 14123(c). However, the director may grant an informal hearing at the request of the provider to determine in the director’s sole discretion if the circumstances surrounding the conviction justify rescinding or otherwise modifying the suspension.

Automatic Suspensions/Mandatory Exclusions. DHCS shall automatically suspend Provider under the following circumstances: (1) Upon notice from the Secretary of the United States Department of Health and Human Services that Provider has been excluded from participation in the Medicare or Medicaid programs. No administrative appeal of a suspension on this ground shall be available to Provider. (Welfare and Institutions Code, § Section 14123 (b)-(c).) (2) If Provider has license(s), certificate(s), or other approval(s) to provide health care services, revoked or suspended by a federal, California, or another state’s licensing, certification, or approval authority; has otherwise lost that/those license(s), certificate(s), or approval(s); or has surrendered that/those license(s), certificate(s), or approval(s) while a disciplinary hearing on that license, certificate, or approval was pending. (Welfare and Institutions Code, § Section 14043.6.) (3) If Provider is convicted of any felony or any misdemeanor involving fraud, or abuse of the Medi-Cal program or any patient, or otherwise substantially related to the qualifications, functions, or duties of a provider of service. Suspension following conviction is not subject to the proceedings under Welfare and Institutions Code, § Section 14123(c). However, the director may grant an informal hearing at the request of the provider to determine in the director’s sole discretion if the circumstances surrounding the conviction justify rescinding or otherwise modifying the suspension.

Automatic Suspensions/Mandatory Exclusions. DHCS shall automatically suspend Provider under the following circumstances: (1) Upon notice from the Secretary of the United States Department of Health and Human Services that Provider has been excluded from participation in the Medicare or Medicaid programs. No administrative appeal of a suspension on this ground shall be available to Provider. (Welfare and Institutions Code, § 14123 (b)-(cSection 14123(b),(c).) (2) If Provider has license(s), certificate(s), or other approval(s) to provide health care services, revoked or suspended by a federal, California, or another state’s licensing, certification, or approval authority; , has otherwise lost that/those license(s), certificate(s), or approval(s); , or has surrendered that/those license(s), certificate(s), or approval(s) while a disciplinary hearing on that license, certificate, or approval was pending. (Welfare and Institutions Code, § Section 14043.6.) (3) If Provider is convicted of any felony or any misdemeanor involving fraud, or abuse of the Medi-Cal program or any patient, or otherwise substantially related to the qualifications, functions, or duties of a provider of service. Suspension following conviction is not subject to the proceedings under Welfare and Institutions Code, § Section 14123(c). However, the director may grant an informal hearing at the request of the provider to determine in the director’s sole discretion if the circumstances surrounding the conviction justify rescinding or otherwise modifying the suspension.