Skip to main content

Advertisement

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