Disqualifying Criminal Convictions
Criminal convictions that disqualify providers from Medicare, Medicaid/PeachCare for Kids, or other health insurance programs
Scope of Disqualification
Any criminal conviction (as defined in the Definitions section of this Manual) or admission in a court of law, Composite State Board of Medical Examiners proceeding, criminal investigation, or administrative proceeding relating to:
- The provision of services under Medicare, Medicaid/PeachCare for Kids, or other health insurance program
- Neglect or abuse of a patient
- The specific violations listed below
| Section | O.C.G.A. Statute | Description |
|---|---|---|
| SPECIFIC CRIMINAL VIOLATIONS | ||
| 404.10.3 | § 30-5-8 | Abuse, neglect, exploitation of a disabled adult or elder person |
| 404.10.4 | § 16-5-1 | Murder |
| 404.10.5 | § 16-5-2 | Involuntary manslaughter |
| 404.10.6 | § 16-8-41 | Armed robbery with a firearm |
| 404.10.7 | § 16-6-5.1 | Sexual assault against persons in custody, detained persons, or patients in hospitals or other institutions |
| 404.10.8 | § 16-6-22.1 | Aggravated sexual battery |
| 404.10.9 | § 16-6-5 | Enticing a child for indecent purposes |
| 404.10.10 | § 16-5-70 | Cruelty to children |
| 404.10.11 | § 16-5-100 | Cruelty to a person 65 years of age or older |
| 404.10.12 | § 16-6-1 | Rape |
| 404.10.13 | § 16-6-4 | Child molestation |
| FELONY OFFENSES BY CHAPTER | ||
| 404.10.14.1 | Title 16, Ch. 5 | Felony offenses: Crimes against the person |
| 404.10.14.2 | Title 16, Ch. 8 | Felony offenses: Offenses involving theft |
| 404.10.14.3 | Title 16, Ch. 9 | Felony offenses: Forgery and fraudulent practices |
| 404.10.14.4 | Title 16, Ch. 13 | Felony offenses: Controlled substances |
| ADDITIONAL FELONY OFFENSES | ||
| 404.10.15.1 | § 16-4-1 | Felony offense: Criminal attempt as it concerns attempted murder |
| 404.10.15.2 | § 16-7-1 | Felony offense: Burglary |
| 404.10.15.3 | § 16-12-100 | Felony offense: Child pornography |
Important Notes
- Scope: This applies to any criminal conviction, admission in court, or administrative proceeding
- Context: Violations must relate to healthcare services, patient care, or the specific crimes listed
- Felony Distinction: Some violations are specifically limited to felony-level offenses within certain chapters
- Age-Specific: Special provisions for crimes against children and elderly persons (65+)