yourstate.us
42 CFR 1003.410

§ 1003.410 Amount of penalties and assessments for Contracting Organization.

United States · 42 CFR — Public Health · Status: effective

Get this as JSONEmbed this
Cite this
Citation
42 CFR 1003.410, § 1003.410 Amount of penalties and assessments for Contracting Organization, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/208442
Permanent ID
ys:prov:208442@1
SHA-256
bf75630a133f1013d676d0b6a6f78d87977c6460753ff799138f1e700b2d8137

The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.

Full text

(a) Penalties. (1) The OIG may impose a penalty of up to $25,000 for each individual violation under § 1001.400, except as provided in this section. (2) The OIG may impose a penalty of up to $100,000 for each individual violation under § 1003.400(a)(3), (a)(5), or (e). (b) Additional penalties. In addition to the penalties described in paragraph (a) of this section, the OIG may impose— (1) An additional penalty equal to double the amount of excess premium charged by the contracting organization for each individual violation of § 1003.400(a)(2). The excess premium amount will be deducted from the penalty and returned to the enrollee. (2) An additional $15,000 penalty for each individual expelled or not enrolled in violation of § 1003.400(a)(3) or (e). (c) Assessments. The OIG may impose an assessment against a contracting organization with a contract under section 1857 or 1860D-12 of the Act (Medicare Advantage or Part D) of not more than the amount claimed in violation of § 1003.400(a)(4) or (a)(5) on the basis of the misrepresentation or falsified information involved. (d) The OIG may impose a penalty or, when applicable, an assessment, against a contracting organization with a contract under section 1857 or 1860D-12 of the Act (Medicare Advantage or Part D) if any of its employees, agents, or contracting providers or suppliers engages in any of the conduct described in § 1003.400(a) through (d).

Legislative history

This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.