Do you agree that you were convicted of a felony that was committed after August
21, 1996?
If you disagree, explain why you disagree. State which exhibits support your
argument and explain why they do.
II. Were you convicted of an offense for which exclusion is required?
The I.G. argues that he must exclude you, because your conviction was of a felony
relating to fraud, theft, embezzlement, breach of fiduciary responsibility or other
financial misconduct that was committed: in connection with the delivery of a
health care item or service; or with respect to any act or omission in a health care
program other than Medicare or a State Medicaid program operated by, or
financed in whole or in part by, any federal, State, or local government agency.
Do you disagree with the I.G.’s argument?
If you disagree, explain why you disagree. State which exhibits support your
argument and explain why they do.
III. Is the length of your exclusion unreasonable? The I.G. argues that the
length of the exclusion that he determined to impose is reasonable. He argues that
there is evidence relating to certain aggravating factors that he says supports the
length of the exclusion.
No
Yes
No
Yes