Civil Monetary Penalties Law

OIG may seek civil monetary penalties and sometimes exclusion for a wide variety of conduct and is authorized to seek different amounts of penalties and assessments based on the type of violation at issue. Penalties range from $10,000 to $50,000 per violation. Some examples of CMPL violations include:

  • presenting a claim that the person knows or should know is for an item or service that was not provided as claimed or is false or fraudulent;
  • presenting a claim that the person knows or should know is for an item or service for which payment may not be made;
  • violating the AKS;
  • violating Medicare assignment provisions;
  • violating the Medicare physician agreement;
  • providing false or misleading information expected to influence a decision to discharge;
  • failing to provide an adequate medical screening examination for patients who present to a hospital emergency department with an emergency medical condition or in labor; and
  • making false statements or misrepresentations on applications or contracts to participate in the Federal health care programs.  Source