Federal Register - September 16, 2021
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Source: Federal Register
Federal Register / Vol. 86, No. 177 / Thursday, September 16, 2021 / Proposed Rules 150.521
Collateral estoppel.
a Where a final decision pertaining to the provider or facilitys liability for acts that violate this part has been rendered in any proceeding in which the provider or facility was a party and had an opportunity to be heard, the provider or facility shall be bound by such decision in any proceeding under this part.
b In a proceeding under this part, a provider or facility is estopped from denying the essential elements of a criminal offense if the proceeding:
1 Is against a provider or facility which has been convicted whether upon a verdict after trial or upon a plea of guilty or nolo contendere of a Federal crime charging fraud or false statements; and 2 Involves the same transactions as in the criminal action.
150.523
Judicial review.
a Any provider or facility against which a final decision imposing a civil money penalty is entered by the ALJ
pursuant to this subpart may obtain
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review in the United States Court of Appeals for the circuit in which the person resides, or where the violation occurred, by filing in such court within 60 days following the date on which such decision becomes final a written petition requesting the decision be modified or set aside. Such review will be conducted pursuant to section 1128Ae of the Social Security Act.
b A provider or facility must exhaust all administrative appeal procedures established under this part before the provider or facility may bring an action in Federal court, as provided in section 1128Ae of the Social Security Act, concerning any penalty imposed pursuant to this part.
c Administrative remedies are exhausted on the date an ALJs initial decision becomes final under 150.453, or the date of the Administrators decision affirming, reversing, modifying, or remanding the ALJs initial decision under 150.457, as applicable.
d After the clerk of the court transmits a copy of the petition
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specified in paragraph a of this section to the Secretary, the Secretary will file in the Court the record in the proceeding as provided in section 2112
of Title 28, United States Code.
150.525
Notice to other agencies.
Whenever a penalty becomes final, the Secretary will notify the following organizations and entities about such action and the reasons for it: The appropriate State or local medical or professional association, the State Department of Health, the appropriate State or local licensing agency or organization, and the appropriate utilization and quality control peer review organization. The Secretary may additionally notify the following entities, as appropriate: The State Department of Insurance or similar agency, the State Attorney General, the Secretary of Labor, the Secretary of the Treasury, or the Director of the U.S.
Office of Personnel Management.
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