What exactly did the HHS decision say about Annette Bosworth and what were the consequences?
Executive summary
The HHS administrative law judge sustained CMS’s placement of Dr. Annette M. Bosworth on the Medicare Preclusion List for ten years, finding that within the prior ten years she had been convicted of a felony offense that CMS reasonably determined was detrimental to the Medicare program and that she failed to report those convictions to CMS [1]. That federal administrative sanction sits alongside state criminal convictions, a suspended sentence with probation and community service, and a state medical license revocation/appeal process, while later state court actions altered some of the underlying criminal findings [2] [3] [4] [5].
1. What the HHS decision said in plain language
The HHS Administrative Law Judge concluded CMS had statutory authority to include Bosworth on the Preclusion List because she had a felony conviction within the prior ten years that CMS reasonably determined could harm the Medicare program; the decision explicitly states she “remains on the Preclusion List for ten years” [1]. The decision also records that Bosworth had been a Medicare-enrolled physician but no longer was, and that she failed to report her 2015 convictions to CMS — a factual point CMS relies on in enforcing program integrity rules [1].
2. The factual and policy basis HHS relied upon
HHS framed the issue as one of trust and reliability in dealings with government programs, noting CMS “relies on the honesty of our Medicare partners” for accurate patient care and billing and that Bosworth’s actions raised “serious concerns” about her truthfulness and reliability when interacting with government entities such as CMS [1]. The administrative finding tied her fitness for Medicare participation to the prior criminal adjudications arising from her 2014 Senate nominating petitions, reasoning those convictions were reasonably detrimental to Medicare’s interests [1].
3. Direct administrative consequences from the HHS ruling
The immediate federal administrative consequence is placement on the Medicare Preclusion List for ten years, which bars enrollment and participation in Medicare during that period — a significant professional and financial restriction for a physician who once billed the program [1]. The ALJ’s order emphasizes the ten‑year preclusion as the remedy CMS is authorized to pursue based on the felony convictions and CMS’s determination that those convictions implicated program integrity [1].
4. Parallel and subsequent state-level consequences and legal shifts
Separately, Bosworth was criminally convicted in 2015 on counts tied to filing false election petitions, sentenced to probation and 500 hours of community service rather than incarceration [2] [6], and the South Dakota medical board voted to revoke her state medical license following those convictions [3]. Over time, state appellate courts modified the criminal record: the South Dakota Supreme Court vacated six perjury counts while affirming convictions for offering false or forged instruments for filing, and later decisions removed perjury convictions from her record even as some false‑filing convictions were upheld [5] [7] [4]. Those state-court changes affected the public and legal framing of her misconduct but do not automatically erase administrative determinations already made by CMS as described in the HHS decision [1].
5. Disputes, perspectives, and reporting limits
HHS and CMS framed the sanction as protecting Medicare’s integrity by excluding a provider whose criminal conduct called her honesty into question [1], while state defense themes emphasized lack of intent, bad advice, or political motivation, arguments that influenced appellate outcomes on narrower perjury counts [7] [4]. The medical board’s rationale for revocation similarly centered on protecting public trust in physicians [3] [8]. The sources document the HHS administrative rationale and the state criminal and licensing aftermath; they do not provide a contemporaneous CMS statement responding to the later state-court vacaturs or a full account of whether CMS has adjusted the federal preclusion in light of subsequent state rulings, so those follow-up administrative actions — if any — cannot be confirmed from the provided reporting [1] [7] [4].