If you disagree, state which of the aggravating factors cited by the I.G. you
believe are not present. Explain why you disagree. State which exhibits
support your argument(s) and explain why they do.
B. If you agree that there is/are an aggravating factor or factors
present in your case but believe that the exclusion is nonetheless not
justified by the presence of that factor or factors, explain your reasons
for your argument. State which exhibits support your arguments and
explain why they do.
C. Do you believe that a mitigating factor or factors exist(s) that
support(s) reducing the length of your exclusion (before answering this
question, read the list of potentially mitigating factors that is set forth
at 42 C.F.R. § 1001.401(c)(3))?
If you believe that a mitigating factor or factors exist(s), state what it is/they
are and explain why the presence of the factor or factors should support
reducing the length of your exclusion. State which exhibits support your
argument(s) and explain why they do.
No
Yes