Table 5 LEIE rules involving fraud
From: Big Data fraud detection using multiple medicare data sources
Rule number | Description |
|---|---|
1128(a)(1) | Conviction of program-related crimes |
1128(a)(2) | Conviction relating to patient abuse or neglect |
1128(a)(3) | Felony conviction relating to health care fraud |
1128(b)(4) | License revocation or suspension |
1128(b)(7) | Fraud, kickbacks and other prohibited activities |
1128(c)(3)(g)(i) | Conviction of two mandatory exclusion offenses 10 years |
1128(c)(3)(g)(ii) | Conviction of 3 mandatory exclusion offenses indefinite |