By Washington News Service / October 13, 2026
The Trump administration is finally moving forward with its plan to give CMS authority to exclude providers from Medicare and Medicaid, according to a notice posted in the Federal Register notice Tuesday (Oct. 13), reviving questions about how the authority would work under two agencies.
HHS Secretary Robert F. Kennedy Jr. announced at a press conference in July HHS’ plan to grant CMS the authority to exclude providers and permanently ban them like the HHS Office of Inspector General (OIG) currently can following investigations.
In the notice posted this week, Kennedy delegated to CMS the immediate authority to exclude providers from agency programs under section 1128(b) of the Social Security Act. Kennedy says CMS’ new authority will “not affect or diminish the Secretary’s previous delegation of these authorities to the Inspector General of the Department of Health and Human Services."
“As the agency directly responsible for administering Medicare and Medicaid, CMS is uniquely positioned to investigate, identify, and develop the evidentiary basis underpinning permissive exclusion determinations,” Kennedy says in the notice. “Formalizing this delegation aligns investigative and enforcement responsibilities within a single operating division, reducing redundancy and improving program integrity outcomes.”
Georgetown University Center for Children and Families researcher Andy Schneider said in an email to Inside Health Policy the notice left him wondering about potential reasons for CMS’ new authority.
“Is CMS unhappy with the way OIG has handled these permissive exclusions?” Schneider asked. “Is there not enough bandwidth in OIG, so CMS is supplementing OIG's investigative and prosecutorial resources? Whatever the reasons, it's not at all clear what happens if the [Inspector General] says [to] exclude and the CMS Administrator doesn't think exclusion is warranted, and vice versa. Will they divvy up the 17 grounds between them so the Secretary can speak with one voice on each?”
IHP asked CMS this summer whether CMS’ exclusion process would work similarly to that of OIG’s, but CMS did not provide an answer. Providers told IHP over the summer that they hoped CMS’ increased authority would not also penalize providers that are not bad actors.