Table 2 Selected LEIE rules
From: The effects of class rarity on the evaluation of supervised healthcare fraud detection models
Rule number | Description | Exclusion period |
|---|---|---|
1128(a)(1) | Conviction of program-related crimes | 5 years |
1128(a)(2) | Conviction due to patient abuse or neglect | 5 years |
1128(a)(3) | Felony conviction due to healthcare fraud | 5 years |
1128(b)(4) | License revocation or suspension | 5 years |
1128(b)(7) | Fraud, kickbacks and other prohibited activities | 5 years |
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 |