Regulations last checked for updates: Nov 24, 2024

Title 42 - Public Health last revised: Nov 19, 2024
§ 1003.220 - Determinations regarding the amount of penalties and assessments and the period of exclusion.

In considering the factors listed in § 1003.140

(a) It should be considered a mitigating circumstance if all the items or services or violations included in the action brought under this part were of the same type and occurred within a short period of time, there were few such items or services or violations, and the total amount claimed or requested for such items or services was less than $5,000.

(b) Aggravating circumstances include—

(1) The violations were of several types or occurred over a lengthy period of time;

(2) There were many such items or services or violations (or the nature and circumstances indicate a pattern of claims or requests for payment for such items or services or a pattern of violations);

(3) The amount claimed or requested for such items or services, or the amount of the overpayment was $50,000 or more;

(4) The violation resulted, or could have resulted, in patient harm, premature discharge, or a need for additional services or subsequent hospital admission; or

(5) The amount or type of financial, ownership, or control interest or the degree of responsibility a person has in an entity was substantial with respect to an action brought under § 1003.200(b)(3).

source: 51 FR 34777, Sept. 30, 1986, unless otherwise noted.
cite as: 42 CFR 1003.220