New OIG FAQs Clarify CMS Exclusion Authority

The U.S. Department of Health and Human Services' (HHS) Office of Inspector General (OIG) recently posted additional FAQs relating to the joint delegation of certain exclusion authority to the Centers for Medicare and Medicaid Services (CMS). On October 14, 2026, the Secretary of the U.S. Department of Health and Human Services (HHS) issued a delegation order that provided CMS with limited authority to exclude participation in federal health care programs, including Medicare and Medicaid, under Section 1128 of the Social Security Act. As a result, both OIG and CMS have parallel authority over permissive exclusions.

The FAQs clarify that only OIG has authority to impose mandatory exclusions, which may cover individuals and entities convicted of Medicare or Medicaid fraud and that OIG will resolve permissive exclusion authority for HHS in False Claim Act matters. However, the FAQs do not provide further details on how permissive exclusion cases will be allocated between OIG and CMS or on how HHS intends to publicize CMS-initiated exclusions, which is still under development.

We will continue to monitor any updates relating to HHS' implementation of CMS' exclusion authority.