Creator: Patrick Connole
HHS Makes Official CMS’s New ‘Exclusion’ Authorities
A notice in the Federal Register made official the new delegation of “exclusion” authority to the administrator of CMS, which will more easily allow the agency to oust SNFs and other providers from Medicare and Medicaid.
A notice last week in the Federal Register made official the new delegation of “exclusion” authority to the administrator of CMS, which will more easily allow the agency to oust SNFs and other providers from the Medicare and Medicaid programs if they are deemed “bad actors” in committing fraud and abuse.
In the notice, HHS Sec. Robert F. Kennedy Jr. delegates “the authorities vested in the Secretary of Health and Human Services under section 1128(b) of the Social Security Act. This delegation revises the limitations from the March 14, 2011, delegation of authority (76 FR 13618), which superseded the September 6, 1984, DOA as to Section F.50.—Limitations of Authority, subsection (1)(c).”
It further said CMS requested exclusion authority “as the agency directly responsible for administering Medicare and Medicaid, CMS is uniquely positioned to investigate, identify, and develop the evidentiary basis underpinning permissive exclusion determinations. Formalizing this delegation aligns investigative and enforcement responsibilities within a single operating division, reducing redundancy and improving program integrity outcomes.”
Other items of importance in the brief notice include:
- The HHS delegation to CMS will be exercised in accordance with the department's applicable policies, procedures, guidelines, and regulations, and the authorities may be redelegated.
- CMS is excluded from conducting hearings and issuing regulations.
- The delegation does not affect or diminish the HHS secretary's previous delegation of these authorities to the Inspector General of HHS.
- All redelegations and edits to this authority are required to be reviewed by the Division of Performance and Organizational Programs, Office of Human Capital, CMS, or its successor.
- The delegation to CMS is effective immediately.
Read the notice at https://www.federalregister.gov/documents/2026/10/14/2026-21001/statement-of-delegation-of-authority.
Comments or questions go to Patrick Connole at pconnole@parkplacelive.com.
