§ 512.592 Remedial action.

(a) Grounds for remedial action. CMS may take one or more remedial actions described in paragraph (b) of this section if CMS determines that the TEAM participant or a downstream participant: (1) Has failed to comply with any of the terms of TEAM, included in this subpart. (2) Has failed to comply with any applicable Medicare program requirement, rule, or regulation. (3) Has taken any action that threatens the health or safety of a beneficiary or other patient. (4) Has submitted false data or made false representations, warranties, or certifications in connection with any aspect of TEAM. (5) Has undergone a change in control that presents a program integrity risk. (6) Is subject to any sanctions of an accrediting organization or a Federal, State, or local government agency. (7) Is subject to investigation or action by HHS (including the HHS Office of Inspector General and CMS) or the Department of Justice due to an allegation of fraud or significant misconduct, including any of the following: (i) Being subject to the filing of a complaint or filing of a criminal charge. (ii) Being subject to an indictment. (iii) Being named as a defendant in a False Claims Act qui tam matter in which the Federal government has intervened, or similar action. (8) Has failed to demonstrate improved performance following any remedial action imposed under this section. (9) Has misused or disclosed beneficiary-identifiable data in a manner that violates any applicable statutory or regulatory requirements or that is otherwise non-compliant with the provisions of the TEAM data sharing agreement. (b) Remedial actions. If CMS determines that one or more grounds for remedial action described in paragraph (a) of this section has taken place, CMS may take one or more of the following remedial actions: (1) Notify the TEAM participant and, if appropriate, require the TEAM participant to notify its downstream participants of the violation. (2) Require the TEAM participant to provide additional information to CMS or its designees. (3) Subject the TEAM participant to additional monitoring, auditing, or both. (4) Prohibit the TEAM participant from distributing TEAM payments, as applicable. (5) Require the TEAM participant to terminate, immediately or by a deadline specified by CMS, its agreement with a downstream participant with respect to TEAM. (6) Require the TEAM participant to submit a corrective action plan in a form and manner and by a date specified by CMS. (7) Discontinue the provision of data sharing and reports to the TEAM participant. (8) Recoup TEAM payments. (9) Reduce or eliminate a TEAM payment otherwise owed to the TEAM participant. (10) Such other action as may be permitted under the terms of this part.