Haroon I. Hameed, M.D., DAB CR6883 (2026)

DECISION

Petitioner, Haroon I. Hameed, M.D., is a physician, licensed in Maryland, who participated in the Medicare program as a supplier of services.  The Centers for Medicare & Medicaid Services (CMS) has revoked his Medicare enrollment pursuant to 42 C.F.R. § 424.535(a)(13) because the Drug Enforcement Administration (DEA) revoked his DEA Certificate of Registration.  CMS has imposed a one-year reenrollment bar and added his name to the Medicare preclusion list. 

Petitioner appeals the revocation. 

I affirm CMS’s determination.  I find that CMS is authorized to revoke Petitioner’s Medicare enrollment and to add his name to the Medicare preclusion list because the DEA revoked his Certificate of Registration.  42 C.F.R. § 424.535(a)(13). 

Background

Statutory and Regulatory Background.  The Medicare program, Title XVIII of the Social Security Act (Act), is a federally-subsidized insurance program that provides

Page 2

health care benefits to the elderly, disabled, and those suffering from end stage renal disease.  Medicare is divided into four parts: 

• Part A is the hospital insurance program.  It covers hospital services, post-hospital extended care, home health services, and hospice care.  Act § 1811 (42 U.S.C. § 1395c);
• Part B, which is voluntary, is the supplementary medical insurance program, covering physician, outpatient, home health,1  and other services.  Act § 1832 (42 U.S.C. § 1395k);
• Part C is the Medicare Advantage program, which allows its participants to enroll in “Medicare + Choice” plans, managed by organizations, such as health maintenance organizations, that receive a fixed payment for each enrollee.  Act § 1851 (42 U.S.C. § 1395w-21); and
• Part D is the voluntary prescription drug benefit program.  Act § 1860D (42 U.S.C. § 1395w-101). 

The Medicare program is administered by CMS, acting on behalf of the Secretary of Health and Human Services.  CMS contracts with Medicare administrative contractors, who process and pay reimbursement claims and perform other duties necessary to carry out program purposes.  Act § 1842 (42 U.S.C. § 1395u).  Contractors pay claims to “providers” (Part A) and “suppliers” (Part B).  Physicians and other practitioners who furnish healthcare services may participate in the program as “suppliers” of services; however, they must enroll in the program in order to receive Medicare payments.  Act § 1861(d), (q), (r) (42 U.S.C. § 1395x(d), (q), (r)); 42 C.F.R. §§ 400.202, 424.505. 

42 C.F.R. § 424.535(a) authorizes CMS to revoke a supplier’s Medicare enrollment and billing privileges on one or more of the grounds set forth under that subsection.  Section 424.535(a)(13) authorizes revocation based on the revocation of a physician’s DEA Certificate of Registration. 

Procedural Background.  In a revocation notice, dated November 5, 2025, the Medicare contractor, Novitas Solutions, advised Petitioner Hameed that it revoked his Medicare enrollment, effective December 5, 2025.  The letter explains that the contractor revoked Petitioner’s Medicare enrollment pursuant to 42 C.F.R. § 424.535(a)(13) because, on October 20, 2025, the DEA had revoked his DEA Certificate of Registration.  CMS Ex. 4

Page 3

at 1.  The contractor also imposed a one-year reenrollment bar, effective 30 days from the postmark date of the notice letter.  CMS Ex. 5 at 3.2 

The letter also advised Petitioner that the contractor added him to CMS’s preclusion list, as authorized by 42 C.F.R. §§ 422.2, 422.222, 423.100, and 423.120(c)(6).  It explained that, if Petitioner requested reconsideration, this action would become effective on the date the reconsidered determination was issued.  CMS Ex. 4 at 1-2. 

Petitioner requested reconsideration.  In a reconsidered determination, dated February 3, 2026, a CMS hearing officer upheld the revocation, the reenrollment bar, and the determination to include Petitioner on the Medicare preclusion list.  CMS Ex. 1.  

Petitioner appealed. 

Decision based on the written record.  CMS has moved for summary judgment.  I agree that no material facts are in dispute and that CMS is entitled to judgment as a matter of law.  42 C.F.R. § 424.535(a)(13).  However, even though summary judgment might be proper, I am not required to decide a case on summary judgment.  Emery County Care and Rehab. Ctr., DAB No. 3006 at 6 (2020). 

In my initial order, I instructed the parties to submit a list of proposed witnesses (if any), along with their complete written direct testimony, submitted in the form of an affidavit made under oath or as a written declaration signed under penalty of perjury.  Acknowledgment and Prehearing Order at 4, 5 (¶¶ 4.c.iv, 8).  Neither party listed any witnesses.  Because there are no witnesses to be examined or cross-examined, an in-person hearing would serve no purpose.  See George Yaplee Medical Ctr. d/b/a Triangle Eye Institute, DAB No. 3003 at 5 (2020) (acknowledging that the Board “has long held that convening a hearing would be pointless, where no witness testimony is offered or all witness testimony is completed in writing and no cross-examination is sought.”).3 

Page 4

Submissions.  With its motion and brief (CMS Br.), CMS submitted five exhibits (CMS Exs. 1-5).  Petitioner filed his own pre-hearing brief and opposition to CMS’s motion (P. Br.), with seven exhibits (P. Exs. 1-7).  In the absence of any objections, I admit into evidence CMS Exs. 1-5 and P. Exs. 1-7. 

Discussion

1.  Because the DEA revoked Petitioner’s Certificate of Registration, CMS was authorized to revoke his Medicare enrollment.  42 C.F.R. § 424.535(a)(13).4 

CMS regulates the Medicare enrollment of providers and suppliers.  Social Security Act (Act) § 1866(j)(1)(A).  It may revoke a physician’s enrollment in the Medicare program if the DEA has revoked his DEA Certificate of Registration.  42 C.F.R. § 424.535(a)(13). 

Revocation of Petitioner’s DEA Certificate of Registration.  The DEA revoked Petitioner’s DEA Certificate of Registration, effective October 20, 2025.  In a decision, published in the Federal Register, the DEA detailed the alarming facts underlying that decision.  Petitioner was a board-certified practitioner of physical medicine and rehabilitation.  He consulted with patients on pain management; he provided pain medications; and he performed surgical interventions to relieve pain.  CMS Ex. 3 (90 Fed. Reg. 45,251 (Sept. 19, 2025). 

The Maryland State Board of Physicians summarily suspended Petitioner’s medical license.  The State Board’s investigation found that Petitioner had seen patients and performed procedures while under the influence of controlled substances and alcohol.  The medical board’s specific findings included: 

• On August 28, 2019, Petitioner performed a radiofrequency ablation instead of the cervical facet block that had been ordered and consented to in writing.
• On February 17, 2020, Petitioner was observed “swaying” while he performed a procedure on a patient.  His speech was slurred; his eyes were bloodshot; and he smelled of alcohol.  Staff suspected that he was “impaired.”
• At work, on May 20, 2020, others observed Petitioner’s disheveled clothing and appearance, glassy and heavy eyes, slurred speech, and lack of coordination.  CMS Ex. 3 at 1 (90 Fed. Reg. 45,251 (Sept. 19, 2025). 

Page 5

In a final decision and order, the State Board found that: 

• Every night between October 2019 and May 2020, Petitioner consumed a combination of oxycodone (a Schedule II opioid), eszopiclone (a Schedule IV sedative), and alcohol.
• On May 5, 2020, Petitioner reported to work intoxicated, having consumed alcohol, oxycodone, and eszopiclone “in excess of the prescribed dose.”
• On “multiple occasions,” including on February 17, 2020, Petitioner saw patients and performed medical procedures while under the influence of an opioid, sedative, and alcohol. 

Id. at 1-2. 

The Medical Board concluded that Petitioner:  1) was guilty of unprofessional conduct in the practice of medicine; 2) was habitually intoxicated; 3) was addicted to or habitually abused a controlled substance; and 4) provided professional services while under the influence of alcohol or while abusing a controlled substance.  CMS Ex. 3 at 2. 

The DEA concurred with the State Board findings and concluded that allowing Petitioner’s continued registration was “inconsistent with the public interest.”  CMS Ex. 3 at 3. 

The DEA also found “clear, unequivocal, and convincing record evidence” that Petitioner “materially falsified” answers to questions on his October 31, 2021 application for renewal of his DEA certificate.  Id. 

Finding that revocation was in the public interest and that Petitioner had not shown that he could be trusted with the responsibility of registration, the DEA ordered that his registration be revoked.  CMS Ex. 3 at 7. 

Legal basis for Medicare enrollment revocation.  The Departmental Appeals Board has consistently held that an administrative law judge’s review of CMS’s determination to revoke a supplier’s Medicare enrollment is limited to deciding whether CMS has established one or more of the grounds specified in section 424.535(a).  Salman K. Akbar, M.D., DAB No. 3226 at 7 (2026); John O. Dimowo, M.D., DAB No. 3101 at 6 (2023); William Garner, M.D., DAB No. 3026 at 16 (2020); Norman Johnson, M.D., DAB No. 2779 at 11 (2017), and cases cited therein.  Although CMS itself has the discretion to consider “unique or mitigating circumstances in deciding whether, or how, to exercise its revocation authority,” I do not.  I may not substitute my discretion for that of CMS in determining whether the revocation is appropriate.  Johnson, DAB No. 2779 at 11, citing

Page 6

Care Pro Home Health, Inc., DAB No. 2723 at 9 n.8 (2016); Abdul Razzaque Ahmed, M.D., DAB No. 2261 at 19 (2009), aff’d, Ahmed v. Sebelius, 710 F. Supp. 2d 167 (D. Mass. 2010).  So long as CMS shows that one of the regulatory bases exists, I must uphold the revocation.  Eva Orticio Villamor-Goubeaux, DAB No. 2997 at 13 (2020); Wassim Younes, M.D. & Wassim Younes, M.D., P.L.C., DAB No. 2861 at 8 (2018) (citing Patrick Brueggeman, D.P.M., DAB No. 2725 at 15 (2016)). 

Here, because CMS has grounds for revoking Petitioner’s Medicare enrollment under section 424.535(a)(13), I must sustain the revocation.  Akbar, DAB No. 3226 at 7 (holding that the revocation of a physician’s DEA Certificate “plainly establishes a lawful basis for CMS to revoke his Medicare enrollment.”); Dimowo, DAB No. 3101 at 7. 

In challenging CMS’s determination, Petitioner divides his argument into three sections – abuse of discretion; pending judicial review; and failure to consider critical evidence.  Underlying each of these arguments is one premise:  that CMS abused its discretion because it did not “meaningfully evaluate critical evidence bearing directly on the seriousness of [his] underlying conduct and [his] present fitness to practice medicine.”  P. Br. at 1. 

Pointing to a state ALJ’s July 29, 2021 recommended decision (P. Ex. 6), Petitioner trivializes the significance of his drug and alcohol abuse, citing the state judge’s conclusion that the “State has not proven that [Petitioner] is habitually intoxicated” nor that he is “physically incompetent.”  This is hardly a ringing endorsement, particularly since the state ALJ also found that Petitioner was guilty of unprofessional conduct in the practice of medicine; that he habitually abused a controlled dangerous substance; and that he “provided professional services while using a narcotic in excess of therapeutic amounts and without valid medical indication.”  P. Ex. 6 at 22.  The ALJ recommended that Petitioner’s license be suspended until Petitioner was in treatment and had been abstinent for six months.  P. Ex. 6 at 23. 

Moreover, the state ALJ’s recommendation was not a final decision.  Petitioner does not mention the State Medical Board’s final decision, issued on November 1, 2021 (three months after the state ALJ issued his recommended decision), which concluded that Petitioner was habitually intoxicated.  CMS Ex. 3 at 2.  

In any event, I am not empowered to review the actions of the State Medical Board or the DEA.  Nor may I “review CMS’s revocation determination for ‘abuse of discretion.’” As the Departmental Appeals Board ruled in Dimowo,

Because we conclude that the regulatory elements in section 424.535(a)(13)(i) are met in this case, we must sustain the revocation regardless of other factors. 

Page 7

DAB No. 3101 at 8. 

When a supplier’s billing privileges are revoked, he may not participate in the Medicare program until the end of his reenrollment bar, which must be for a minimum period of one year but no more than ten years (except under circumstances that don’t apply here), depending on the severity of the underlying offense.  42 C.F.R. § 424.535(c)(1).  Here, CMS imposed a one-year reenrollment bar, which is the statutory minimum.5 

2.  CMS acted within its authority when it added Petitioner to its preclusion list because his Medicare privileges were revoked for conduct detrimental to the best interests of the Medicare program, and he is under a reenrollment bar.  I have no authority to review CMS’s determination as to the length of time he remains on the preclusion list. 

The preclusion list.  Effective January 1, 2019, CMS implemented a “preclusion list” as part of its effort to “prevent fraud, waste, and abuse, and to protect Medicare enrollees,” particularly with respect to prescription drug abuse.6   Pursuant to 42 C.F.R. § 422.2 (Part C) and 42 C.F.R. § 423.100 (Part D), CMS’s “preclusion list” includes individuals and entities that: 

• are currently revoked from Medicare enrollment, are under an active reenrollment bar, and CMS determines that the underlying conduct leading to the revocation is detrimental to the best interests of the Medicare program; or
• have engaged in behavior for which CMS could have revoked the prescriber, individual, or entity had it been enrolled in the Medicare program, and CMS determines that the underlying conduct that would have led to the revocation is detrimental to the best interests of the Medicare program. 

42 C.F.R. §§ 422.2; 423.100 (defining “preclusion list”). 

Page 8

In determining whether the underlying conduct is detrimental to the best interests of the Medicare program, CMS considers three factors:  A) the seriousness of the conduct; B) the degree to which the individual’s conduct could affect the integrity of the Medicare program; and C) any other evidence that CMS deems relevant to its determination. 

Review of Petitioner’s inclusion on the preclusion list.  My review here is limited to whether CMS had the authority to include Petitioner on the preclusion list.  42 C.F.R. § 498.3(b)(20); see 83 Fed. Reg. 16,642-16643 (Apr. 16, 2018) (explaining that appeals are limited to the individual’s inclusion on the preclusion list).  See Wendell Foo, M.D., DAB No. 2904 at 3 (2018); Wassim Younes, M.D., P.L.C., DAB No. 2861 at 8 (2018), citing Patrick Brueggeman, D.P.M., DAB No. 2725 at 15 (2016). 

I agree that the conduct leading to the DEA’s revoking Petitioner’s Certificate of Registration was very serious.  As discussed above, he habitually abused alcohol and controlled substances; he provided patient care while impaired; and he misused his authority to prescribe prescription drugs.  I also agree that his inappropriate use of controlled substances represents a serious threat to the Medicare program and to the health and safety of its beneficiaries.  Indeed, misuse of controlled substances is exactly the type of conduct the preclusion list is meant to address.  Further, as the DEA concluded, Petitioner did not unequivocally accept responsibility for his actions; he attempted to minimize their significance, and, in applying to renew his DEA certificate, he falsified his answers.  

Having determined that CMS properly added Petitioner to the preclusion list, I have no authority to review CMS’s determination as to how long he remains there.  See 42 C.F.R. § 498.3(b); Vijendra Dave, M.D., DAB No. 2672 at 9-12 (2016) (limiting ALJ review to the determinations in section 498.3(b)). 

Conclusion

I affirm CMS’s determinations.  CMS was authorized to revoke Petitioner Hameed’s Medicare enrollment because the DEA revoked his Certificate of Registration.  42 C.F.R. § 424.535(a)(13). 

CMS was also authorized to include Petitioner on the preclusion list because his Medicare enrollment was revoked for conduct deemed detrimental to the best interests of the Medicare program, and because he is under a reenrollment bar.