HHS Delegates Provider Exclusion Authority to CMS Administrator
HHS Secretary Robert F. Kennedy Jr. delegated to the CMS administrator the secretary's permissive exclusion authority under Section 1128(b) of the Social Security Act, allowing CMS to exclude individual providers and entities from Medicare and Medicaid. Published in the Federal Register on October 14, the delegation took effect immediately and was requested by CMS to consolidate investigative and enforcement functions within the agency that administers the programs. Grounds for exclusion include misdemeanor healthcare fraud or controlled substance convictions, license revocations, excessive billing, kickbacks, and false statements on enrollment applications. The HHS inspector general's existing exclusion authority is unaffected, and CMS cannot hold hearings or issue regulations under the new delegation; the notice also ratifies any prior actions taken under the authority before it formally took effect.