www.federalregister.gov HHS Delegates Exclusion Authority to CMS for Healthcare Fraud
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- •HHS delegated permissive exclusion authority to CMS effective October 14, 2026.
- •CMS can now investigate and exclude individuals/entities from federal healthcare programs.
- •The authority does not include conducting hearings or issuing regulations.
On October 14, 2026, the HHS Office of Inspector General delegated permissive exclusion authority to the CMS, enhancing its ability to investigate healthcare fraud. This delegation allows CMS to exclude individuals and entities from federal healthcare programs, aligning enforcement responsibilities and improving program integrity. HHS Secretary Robert F. Kennedy, Jr. stated that CMS is well-positioned to handle these investigations due to its direct role in administering Medicare and Medicaid. The delegation does not include the authority to conduct hearings or issue regulations, which remains with HHS-OIG. The change is effective immediately, but details on coordination with HHS-OIG and the Department of Justice are still being developed. The delegation is part of ongoing efforts to combat healthcare fraud under the Social Security Act.
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