[□=□] □ □ □
[lemma=□] □ □ □
[tag=□] □ □ □
Finally , I find that exclusion for conspiracy to possess with an intent to distribute controlled substances suits the remedial purposes of section 1128 of the Act. Petitioner argues that Section 1128 ( a ) ( 4 ) was clearly designed to exclude only those who are drug traffickers not minor drug users . The ALJ found that section 1128 ( a ) ( 1 ) of the Act is applicable not only to cases of actual fraud against the Medicare and Medicaid programs , but also to convictions related to the delivery of an item or service where " financial misconduct against the program had or could have had an impact on the delivery of health care items or services . The Petitioners did not directly challenge the ALJ 's analysis of the Petitioners ' previous arguments , but argued here for the first time that section 1128 ( c ) requires the Secretary to promulgate regulations prior to the effective date of any exclusion . Her first error is her assumption , implicit in the language noted above , that section 1128 ( a ) ( 1 ) is applicable only to cases of expressly charged Medicare and Medicaid fraud , and only in situations of direct abuse of the victim program by the convicted individual . Most important , though , even if the pleas were not " knowingly and willfully " made , the record amply supports the ALJ 's conclusion that the guilty pleas were accepted by the State courts , which is all that section 1128 ( i ) requires .