20 CFR 404.1503a
§ 404.1503a Program integrity.
United States · 20 CFR — Employees' Benefits · Status: effective
Cite this
- Citation
- 20 CFR 404.1503a, § 404.1503a Program integrity, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/78708
- Permanent ID
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20580cb0773a01c63fb9ca9fa8e5174ac33590f5179622028f6813d0738294ca
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Full text
We will not use in our program any individual or entity, except to provide existing medical evidence, who is currently excluded, suspended, or otherwise barred from participation in the Medicare or Medicaid programs, or any other Federal or Federally-assisted program; whose license to provide health care services is currently revoked or suspended by any State licensing authority pursuant to adequate due process procedures for reasons bearing on professional competence, professional conduct, or financial integrity; or who, until a final determination is made, has surrendered such a license while formal disciplinary proceedings involving professional conduct are pending. By individual or entity we mean a medical or psychological consultant, consultative examination provider, or diagnostic test facility. Also see §§ 404.1519 and 404.1519g(b).
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.