Skip to main content


U.S. flag
      An official website of the United States government
              Here’s how you know
        Here’s how you knowDot gov**Official websites use .gov**
                 A **.gov** website belongs to an official government organization in the United States.
                  HTTPS**Secure .gov websites use HTTPS**
                 A **lock** (A locked padlock) or **https://** means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites. 
  Menu Close
          HHS Search block
    Search
        








  
  
    

  
      

                                      About HHS
    
                        
                              
      
      
      Programs & Services
    
                        
                              
      
      
      Grants & Contracts
    
                        
                              
      
      
      Laws & Regulations Breadcrumb
    Home
                              About
                              Agencies
                              DAB
                              Decisions
                              ALJ Decisions
                              2020
                              Gregg J. Williams, DPM, MBA, DAB CR5536 (2020)
 Navigate to:
  Departmental Appeals Board (DAB)
    
                                                  
                                                    
            
      
      
      
      About DAB
                                            
            
            Organizational Overview
    
                                                  
                              
            
      
      
      
      Who are the Judges?
    
                                                  
                              
            
      
      
      
      DAB Divisions
    
                                                  
                              
            
      
      
      
      Contact DAB
    
                                                  
                                                    
            
      
      
      
      Filing an Appeal Online
                                            
            
            DAB E-File
    
                                                  
                              
            
      
      
      
      Medicare Operations Division (MOD) E-File
    
                                                  
                                                    
            
      
      
      
      Different Appeals at DAB
                                            
            
            Appeals to DAB Administrative Law Judges (ALJs)
                          
            
            Forms
    
                                                  
                              
            
      
      
      
      Procedures
    
                                                                
                                                    
            
      
      
      
      Appeals to Board
                          
            
            Practice Manual
    
                                                  
                              
            
      
      
      
      Guidelines
    
                                                  
                              
            
      
      
      
      Regulations
    
                                                  
                              
            
      
      
      
      National Coverage Determination Complaints
    
                                                                
                                                    
            
      
      
      
      Appeals to the Medicare Appeals Council (Council)
                          
            
            Forms
    
                                                  
                              
            
      
      
      
      Fully Integrated Duals Advantage (FIDA) Demonstration Project
    
                                                  
                                                    
            
      
      
      
      Alternative Dispute Resolution Services
                                            
            
            Sharing Neutrals
    
                                                  
                              
            
      
      
      
      ADR Training
    
                                                  
                              
            
      
      
      
      Other ADR Services
    
                                                  
                                                    
            
      
      
      
      DAB Decisions
                                            
            
            Board Decisions
    
                                                  
                              
            
      
      
      
      DAB Administrative Law Judge (ALJ) Decisions
    
                                                  
                              
            
      
      
      
      Medicare Appeals Council (Council) Decisions
    
                                    
                              
            
      
      
      
      Stakeholder Feedback
    
                                                  
                                                    
            
      
      
      
      Careers
                                            
            
            Open Career Opportunities
    
                                                  
                              
            
      
      
      
      Internships & ExternshipsText resize icon

                    




Gregg J. Williams, DPM, MBA, DAB CR5536 (2020)








  
  
    

  
      
Department of Health and Human Services 
    DEPARTMENTAL APPEALS BOARD
          Civil Remedies Division





Gregg J. Williams, DPM, MBA
	(NPI: 1346252426; PTANS: 5H2896677, 5H289DF70)
	Petitioner,
v.
Centers for Medicare & Medicaid Services.
Docket No. C-20-112Decision No. CR5536February 18, 2020

        
              
    

      DECISION
I sustain the determination of a Medicare contractor, as affirmed on reconsideration, to revoke the Medicare enrollment and billing privileges of Petitioner, Gregg J. Williams, DPM, MBA. The contractor, acting on behalf of the Centers for Medicare & Medicaid Services (CMS), may revoke Petitioner’s participation because Petitioner failed to comply with regulatory reporting requirements. Specifically, on two occasions Petitioner failed to report that his license to provide health care was suspended.
I. Background
Pursuant to my initial pre-hearing order, CMS filed a motion for summary judgment or, alternatively, for a decision based on the written record.  CMS filed a brief, incorporating a motion for summary judgment, and proposed exhibits that it identified as CMS Ex. 1-CMS Ex. 13.  In response, Petitioner filed two documents that he identified as “outlines” of his arguments along with 47 separate documents that he intends I receive as exhibits.  He did not place exhibit numbers on these documents.  However, they are entered into the Departmental Appeals Board e-filing system as exhibits 1-46 and 43A.
Page 2
Neither CMS nor Petitioner offered the sworn testimony of a proposed witness or witnesses.
I find it unnecessary that I decide whether the criteria are met for summary judgment.  There is no need to convene an in-person hearing inasmuch as neither CMS nor Petitioner offered testimony.  I decide this case based on the parties’ written exchanges.  I receive CMS Ex. 1-CMS Ex. 13 and all of Petitioner’s exhibits into the record.
**II.  Issue, Findings of Fact and Conclusions of Law**
**A.   Issue**
The issue is whether a contractor, acting on behalf of CMS, may revoke Petitioner’s Medicare participation and billing privileges.
**B.   Findings of Fact and Conclusions of Law**
CMS may revoke a supplier’s Medicare participation and billing privileges for failing to comply with reporting requirements as stated at 42 C.F.R. § 424.516(d).  42 C.F.R. § 424.535(a)(9).  The reporting requirements explicitly instruct a participating supplier to report any adverse legal action to a contractor or CMS within 30 days of its occurrence.  42 C.F.R. § 424.516(d)(1)(ii).  An adverse action for which reporting is mandatory includes suspension or revocation by any state authority of a license to provide health care.  42 C.F.R. § 424.502.
Effective April 6, 2018, the Louisiana State Board of Medical Examiners suspended Petitioner’s license to provide health care.  CMS Ex. 4.  The reporting requirements that I have discussed imposed on Petitioner the duty to report his license suspension to the contractor or to CMS within 30 days.  Failure to do so would be a basis to revoke Petitioner’s Medicare participation and billing privileges.
Petitioner failed to report the license suspension.  Moreover, on two occasions subsequent to April 6, 2018, Petitioner affirmatively denied to the contractor and to CMS that he was subject to an adverse action.  On November 13, 2018 and on January 4, 2019, Petitioner signed and filed Medicare enrollment applications.  CMS Exs. 5 and 12.  On each occasion Petitioner checked “no” as a response to a question asking him whether he had been subject to any adverse actions.  CMS Exs. 5 at 29; 12 at 25.
Petitioner’s failure to report suspension of his license and his subsequent misrepresentations provided the contractor with authority to revoke Petitioner’s participation and billing privileges.  The contractor’s action plainly is authorized by the facts and law.
Page 3
I have considered Petitioner’s arguments, made in his request for reconsideration, his hearing request, and in the statements he submitted in reply to CMS’s hearing exchange, and I find them to be without merit.
At no point does Petitioner credibly deny that he failed to report his license suspension or that he misrepresented to the contractor that he was not subject to adverse actions. Petitioner admits that he knew, prior to submitting the November 13, 2018, and January 4, 2019 applications, that his health care license had been suspended. Indeed, Petitioner concedes that, on April 27, 2018, he was told by a hospital administrator that he could no longer see patients in that hospital due to the suspension of his license. Petitioner’s Hearing Request at 1. He thus admits knowledge of his license suspensBion prior to falsely representing – on November 13, 2018, and January 4, 2019 – that he was not subject to any adverse action.
Petitioner’s arguments fall into two categories. First, Petitioner asserts, in his hearing request, that a representative of the contractor did not deal with him in a professional manner. As a corollary to this argument, Petitioner contends that the contractor’s procedures are overly bureaucratic and not informative. These arguments do not respond at all to the undenied facts of this case. Whatever the status of Petitioner’s relationship with the contractor and its employees, the facts are that Petitioner failed to comply with reporting requirements and, on two occasions, knowingly misrepresented whether his license had been suspended.
Second, Petitioner discusses at considerable length disruptive events in his personal life, events that include: a difficult divorce and subsequent legal entanglements and problems associated with maintaining his podiatric practice. These arguments are essentially equitable. What Petitioner seems to be saying is that he merits forbearance due to the hardships and personal problems that he has encountered.
I have no authority to address these arguments. *US Ultrasound*, DAB No. 2302 at 8 (2010).
I note that the State of Louisiana reinstated Petitioner’s health care license effective May 22, 2019. CMS Ex. 2 at 4. That action does not derogate from the contractor’s or CMS’s authority to revoke Petitioner’s Medicare participation and billing privileges. The authority to revoke flows from Petitioner’s failure to comply with Medicare reporting requirements and misrepresentations in the November 13, 2018, and January 4, 2019 enrollment applications.
Page 4
Finally, I note that the contractor imposed a three-year bar on reenrollment. CMS Ex. 3 at 2. I have no authority to address the length of a debarment action. 42 C.F.R. §§ 424.535(c), 498.3(b).
  
          /s/
        Steven T. Kessel

                      Administrative Law Judge Back to top
    Contact HHS
    
                        
                                            
      
      
      Careers
    
                        
                                            
      
      
      HHS FAQs
    
                        
                                            
      
      
      Nondiscrimination NoticeHHS Archive
    
                        
                                            
      
      
      Accessibility Statement
    
                        
                                            
      
      
      Privacy Policy
    
                        
                                            
      
      
      Viewers & PlayersBudget/Performance
    
                        
                                            
      
      
      Inspector General
    
                        
                                            
      
      
      Web Site Disclaimers
    
                        
                                            
      
      
      EEO/No Fear ActFOIA
    
                        
                                            
      
      
      The White House
    
                        
                                            
      
      
      USA.gov
    
                        
                                            
      
      
      Vulnerability Disclosure Policy
        Sign Up for Email Updates

Receive the latest updates from the Secretary, Blogs, and News Releases.

Sign Up
  HHS Headquarters
          200 Independence Avenue, S.W.
                  Washington, D.C. 20201
                  Toll Free Call Center: 1-877-696-6775​ Disclaimer Policy: Links with this icon () mean that you are leaving the HHS website. The Department of Health and Human Services (HHS) cannot guarantee the accuracy of a non-federal website.
                  Linking to a non-federal website does not mean that HHS or its employees endorse the sponsors, information, or products presented on the website. HHS links outside of itself to provide you with further information.
                  You will be bound by the destination website's privacy policy and/or terms of service when you follow the link.
                  HHS is not responsible for Section 508 compliance (accessibility) on private websites. For more information on HHS's web notification policies, see Website Disclaimers.
 Continue
                  Go back