42 CFR §1003.420

1. (a)Such violations were of several types or occurred over a lengthy period of time;
2. (b)There were many such violations (or the nature and circumstances indicate a pattern of incidents);
3. (c)The amount of money, remuneration, damages, or tainted claims involved in the violation was $15,000 or more; or
4. (d)Patient harm, premature discharge, or a need for additional services or subsequent hospital admission resulted, or could have resulted, from the incident; and
5. (e)The contracting organization knowingly or routinely engaged in any prohibited practice that acted as an inducement to reduce or limit medically necessary services provided with respect to a specific enrollee in the organization.