final adverse action

(1) Final adverse action (A) In general The term “final adverse action” includes: (i) Civil judgments against a health care provider, supplier, or practitioner in Federal or State court related to the delivery of a health care item or service. (ii) Federal or State criminal convictions related to the delivery of a health care item or service. (iii) Actions by Federal agencies responsible for the licensing and certification of health care providers, suppliers, and licensed health care practitioners, including— (I) formal or official actions, such as revocation or suspension of a license (and the length of any such suspension), reprimand, censure or probation, (II) any dismissal or closure of the proceedings by reason of the provider, supplier, or practitioner surrendering their license or leaving the State or jurisdiction (III) any other loss of license or the right to apply for, or renew, a license of the provider, supplier, or practitioner, whether by operation of law, voluntary surrender, non-renewability, or otherwise, or (IV) any other negative action or finding by such Federal agency that is publicly available information. (iv) Exclusion from participation in a Federal health care program (as defined in section 1320a–7b(f) of this title ). (v) Any other adjudicated actions or decisions that the Secretary shall establish by regulation. (B) Exception The term does not include any action with respect to a malpractice claim.


42 USC § 1320a-7e(g)(1)

Scoping language

For purposes of this section
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