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What is the Federal Civil Monetary Penalties Law ?

Posted by Tracy Green | May 27, 2018

The Civil Monetary Penalties Law is set forth at 42 United States Code Section 1320a-7a.
Under it, the Office of Inspector General (OIG) may seek civil monetary penalties (CMPL) 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 Anti-Kickback Statute (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.

About the Author

Tracy Green

Past recipient of the Public Counsel Law Center's "Outstanding Advocate" Award, Tracy Green is a founding partner of Green & Associates. She combines more than 25 years of experience with a strategic...

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