Common use of Entities Which Could Be Excluded Clause in Contracts

Entities Which Could Be Excluded. Under Section 1128(b)(8) of the Social Security Act are entities in which a person who is an officer, director, agent or managing employee of the entity, or a person who has direct or indirect ownership or control interest of 5% or more in the entity has: a. Been convicted of the following crimes: 1) Program-related crimes (i.e., any criminal offense related to the delivery of an item or service under Medicare or Medicaid (see Section 1128(a)(1) of the Act)); 2) Patient abuse (i.e., criminal offense relating to abuse or neglect of patients in connection with the delivery of health care (see Section 1128(a)(2) of the Act)); 3) Fraud (i.e., a state or federal crime involving fraud, theft, embezzlement, breach of judiciary responsibility, or other financial misconduct in connection with the delivery of health care or involving an act or omission in a program operated by or financed in whole or part by federal, state or local government (see Section 1128(b)(1) of the Act)); 4) Obstruction of an investigation (i.e., conviction under state or federal law of interference or obstruction of any investigation into any criminal offense described in subsections a, b, or c (see Section 1128(b)(2) of the Act)); or 5) Offenses relating to controlled substances (i.e., conviction of a state or federal crime relating to the manufacture, distribution, prescription or dispensing of a controlled substance (see Section 1128(b)(3) of the Act)). b. Been excluded, debarred, suspended, otherwise excluded, or is an affiliate (as defined in such Act) of a person described above from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulations issued pursuant to Executive Order 12549 or under guideline implementing such order. c. Been assessed a civil monetary penalty under Section 1128A of the Act.--Civil monetary penalties can be imposed on individual providers, as well as on provider organizations, agencies, or other entities by the DHHS Office of Inspector General. Section 1128A authorizes their use in case of false or fraudulent submittal of claims for payment, and certain other violations of payment practice standards. (See Section 1128(b)(8)(B)(ii) of the Act.)

Entities Which Could Be Excluded. Under Section 1128(b)(8) of the Social Security Act Act.--These are entities in which a person who is an officer, director, agent or managing employee of the entity, or a person who has direct or indirect ownership or control interest of 5% 5 percent or more in the entity has: a. Been convicted of the following crimes: 1) Program-Program related crimes (crimes, i.e., any criminal offense related to the delivery of an item or service under Medicare or Medicaid (see Section 1128(a)(1) of the Act)); 2) Patient abuse (abuse, i.e., criminal offense relating to abuse or neglect of patients in connection with the delivery of health care (see Section 1128(a)(2) of the Act));; HMO Contract for January 1, 2000 - December 31, 2001 3) Fraud (Fraud, i.e., a state State or federal Federal crime involving fraud, theft, embezzlement, breach of judiciary fiduciary responsibility, or other financial misconduct in connection with the delivery of health care or involving an act or omission in a program operated by or financed in whole or part by federalFederal, state State or local government (see Section 1128(b)(1) of the Act)); 4) Obstruction of an investigation (investigation, i.e., conviction under state State or federal Federal law of interference or obstruction of any investigation into any criminal offense described in subsections a, b, or c (see Section 1128(b)(2) of the Act)); ): or 5) Offenses relating to controlled substances (substances, i.e., conviction of a state State or federal Federal crime relating to the manufacture, distribution, prescription or dispensing of a controlled substance (see Section 1128(b)(3) of the Act)). b. Been excludedExcluded, debarredDebarred, suspended, otherwise excluded, Suspended or is an affiliate (as defined in such Act) of a person described above Otherwise Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- non procurement activities under regulations issued pursuant to Executive Order No. 12549 or under guideline implementing such order. c. Been assessed Assessed a civil monetary penalty Civil Monetary Penalty under Section 1128A of the Act.--Civil Act. --Civil monetary penalties can be imposed on individual providers, as well as on provider organizations, agencies, or other entities by the DHHS Office of Inspector General. Section 1128A authorizes their use in case of false or fraudulent submittal of claims for payment, and certain other violations of payment practice standards. (See Section 1128(b)(8)(B)(ii) of the Act.)

Entities Which Could Be Excluded. Under Section 1128(b)(8) of the Social Security Act are entities in which a person who is an officer, director, agent or managing employee of the entity, or a person who has direct or indirect ownership or control interest of 5% or more in the entity has: a. 1) Been convicted of the following crimes: 1a) Program-Program related crimes crimes, (i.e., any criminal offense related to the delivery of an item or service under Medicare or Medicaid (see Section 1128(a)(1) of the Act)); 2b) Patient abuse (i.e., criminal offense relating to abuse or neglect of patients in connection with the delivery of health care (see Section 1128(a)(2) of the Act)); 3c) Fraud Fraud, (i.e., a state or federal crime involving fraud, theft, embezzlement, breach of judiciary responsibility, or other financial misconduct in connection with the delivery of health care or involving an act or omission in a program operated by or financed in whole or part by federal, state or local government (see Section 1128(b)(1) of the Act)); 4d) Obstruction of an investigation investigation, (i.e., conviction under state or federal law of interference or obstruction of any investigation into any criminal offense described in subsections a, b, or c (see Section 1128(b)(2) of the Act)); or 5e) Offenses relating to controlled substances substances, (i.e., conviction of a state or federal crime relating to the manufacture, distribution, and prescription or dispensing of a controlled substance (see Section 1128(b)(3) of the Act)). b. 2) Been excluded, debarred, suspended, otherwise excluded, or is an affiliate (as defined in such Act) of a person described C(1)(a) above from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- non-procurement activities under regulations issued pursuant to Executive Order No. 12549 or under guideline guidelines implementing such order. c. 3) Been assessed a civil monetary penalty under Section section 1128A of the Act.--Civil Act. Civil monetary penalties can be imposed on individual providers, as well as on provider organizations, agencies, or other entities by the DHHS Office of Inspector General. Section 1128A authorizes their use in case of false or fraudulent submittal of claims for payment, and certain other violations of payment practice standards. standards (See see Section 1128(b)(8)(B)(ii) of the Act).)

Entities Which Could Be Excluded. Under Section 1128(b)(8) of the Social Security Act are entities in which a person who is an officer, director, agent or managing employee of the entity, or a person who has direct or indirect ownership or control interest of 5% or more in the entity has: a. Been convicted of the following crimes: 1) Program-Program related crimes crimes, (i.e., any criminal offense related to the delivery of an item or service under Medicare or Medicaid (see Section 1128(a)(1) of the Act)); 2) Patient abuse (i.e., criminal offense relating to abuse or neglect of patients in connection with the delivery of health care (see Section 1128(a)(2) of the Act)); 3) Fraud Fraud, (i.e., a state or federal crime involving fraud, theft, embezzlement, breach of judiciary responsibility, or other financial misconduct in connection with the delivery of health care or involving an act or omission in a program operated by or financed in whole or part by federal, state or local government (see Section 1128(b)(1) of the Act)); 4) Obstruction of an investigation investigation, (i.e., conviction under state or federal law of interference or obstruction of any investigation into any criminal offense described in subsections a, b, or c (see Section 1128(b)(2) of the Act)); or 5) Offenses relating to controlled substances substances, (i.e., conviction of a state or federal crime relating to the manufacture, distribution, and prescription or dispensing of a controlled substance (see Section 1128(b)(3) of the Act)). b. Been excluded, debarred, suspended, otherwise excluded, or is an affiliate (as defined in such Act) of a person described above above) from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulations issued pursuant to Executive Order 12549 or under guideline implementing such order. c. Been assessed a civil monetary penalty under Section 1128A of the Act.--Civil monetary penalties can be imposed on individual providers, as well as on provider organizations, agencies, or other entities by the DHHS Office of Inspector General. Section 1128A authorizes their use in case of false or fraudulent submittal of claims for payment, and certain other violations of payment practice standards. (See Section 1128(b)(8)(B)(ii) of the Act.)