42 CFR §1003.410
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (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).