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United States Department of Health and Human Services
DEPARTMENTAL APPEALS BOARD
Civil Remedies Division
In the Case of:
Date:
Petitioner,
- v. -
The Inspector General.
INFORMAL BRIEF OF PETITIONER
The Inspector General (I.G.) argues that he is authorized to exclude you from
participating in Medicare, Medicaid, and other federally-funded health care
programs, because you were suspended, excluded, or otherwise sanctioned under a
federal or State health care program as is described at section 1128(b)(5) of the
Social Security Act. The length of the exclusion is for a period of time that is not
less than the period during which you are suspended, excluded, or otherwise
sanctioned plus at least _____ additional years.
The issues in this case are whether the I.G. is authorized to exclude you and
whether the length of the exclusion is reasonable.
I. Were you suspended, excluded, or otherwise sanctioned under a federal or
State health care program under the circumstances that are described at
section 1128(b)(5)?
Docket No. C-
-
)
)
)
)
)
)
)
)
)
)
No
Yes
XXX
XX
A. Do you agree that you were suspended, excluded, or otherwise
sanctioned by a federal or a State health care program?
If you disagree, explain why you disagree. State which exhibits support
your argument and explain why they do.
B. Do you agree that you were suspended, excluded, or otherwise
sanctioned for reasons bearing on your professional competence,
professional performance, or financial integrity?
If you disagree, explain why you disagree. State which exhibits support
your argument and explain why they do.
II. 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.
A. Do you disagree with the I.G.’s identification of aggravating factors
in your case?
No
Yes
No
Yes
No
Yes
If you disagree, state which of the aggravating factors cited by the I.G. you
believe are not present. Explain why you disagree. State which exhibits
support your argument(s) and explain why they do.
B. If you agree that there is/are an aggravating factor or factors
present in your case but believe that the exclusion is nonetheless not
justified by the presence of that factor or factors, explain your reasons
for your argument. State which exhibits support your arguments and
explain why they do.
C. Do you believe that a mitigating factor or factors exist(s) that
support(s) reducing the length of your exclusion (before answering this
question, read the list of potentially mitigating factors that is set forth
at 42 C.F.R. § 1001.501(b)(3))?
If you believe that a mitigating factor or factors exist(s), state what it is/they
are and explain why the presence of the factor or factors should support
reducing the length of your exclusion. State which exhibits support your
argument(s) and explain why they do.
No
Yes
III. Do you believe that an in-person hearing is necessary to decide your
case?
Do you have any testimony that you wish to offer at an in-person hearing?
If you have testimony that you wish to offer, provide the following:
1. The name of each witness whose testimony you want to offer.
2. A description of each witness’ proposed testimony and an explanation of
why you believe that the testimony relates to any of the arguments you
want to offer in connection with items I and II.
3. An explanation of why the proposed testimony does not duplicate
something that is already stated in an exhibit.
Yes
No
No
Yes
IV. Do you have any other arguments you wish to make? If so, please state
them here. State which exhibits support your argument(s) and explain why they
do.
Petitioner or Petitioner’s Representative
Date:
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Completed 23 February 2020

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