Section 1128(b)(6)(A) of the Act provides for the permissive exclusion from Federal health care programs of any provider or supplier that submits a claim based on costs or charges to the Medicare or Medicaid programs that is ‘‘substantially in excess’’ of its usual charge or cost, unless the Secretary finds there is ‘‘good cause’’ for the higher charge or cost. The exclusion provision does not require a provider to charge everyone the same price; nor does it require a provider to offer Medicare or Medicaid its ‘‘best price.’’ However, providers cannot routinely charge Medicare or Medicaid substantially more than they usually charge others. Hospitals have raised concerns regarding the impact of the exclusion authority on hospital services, and the OIG is considering those concerns in the context of the rulemaking process. The OIG’s policy regarding application of the exclusion authority to discounts offered to uninsured and underinsured patients is discussed below.