[Federal Register Volume 84, Number 214 (Tuesday, November 5, 2019)]
[Rules and Regulations]
[Pages 59549-59567]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-23955]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

45 CFR Part 102

RIN 0991-AC0


Annual Civil Monetary Penalties Inflation Adjustment

AGENCY: Office of the Assistant Secretary for Financial Resources, 
Department of Health and Human Services.

ACTION: Final rule.

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SUMMARY: The Department of Health and Human Services is updating its 
regulations to reflect required annual inflation-related increases to 
the civil monetary penalties in its regulations, pursuant to the 
Federal Civil Penalties Inflation Adjustment Act Improvements Act of 
2015 and is making a technical change to correct an error in the 
regulation.

DATES: This rule is effective November 5, 2019.

FOR FURTHER INFORMATION CONTACT: David Dasher, Deputy Assistant 
Secretary, Office of Acquisitions, Office of the Assistant Secretary 
for Financial Resources, Room 536-H, Hubert Humphrey Building, 200 
Independence Avenue SW, Washington DC 20201; 202-205-0706.

SUPPLEMENTARY INFORMATION: 

I. Background

    The Federal Civil Penalties Inflation Adjustment Act Improvements 
Act of 2015 (Sec. 701 of Pub. L. 114-74) (the ``2015 Act'') amended the 
Federal Civil Penalties Inflation Adjustment Act of 1990 (Pub. L. 101-
410, 104 Stat. 890 (1990)), which is intended to improve the 
effectiveness of civil monetary penalties (CMPs) and to maintain the 
deterrent effect of such penalties, requires agencies to adjust the 
civil monetary penalties for inflation annually.
    The Department of Health and Human Services (HHS) lists the civil 
monetary penalty authorities and the penalty amounts administered by 
all of its agencies in tabular form in 45 CFR 102.3, which was issued 
in an interim final rule published in the September 6, 2016 Federal 
Register (81 FR 61538). Annual adjustments were subsequently published 
on February 3, 2017 (82 FR 9175) and on October 11, 2018 (83 FR 51369).

II. Calculation of Adjustment

    The annual inflation adjustment for each applicable civil monetary 
penalty is determined using the percent increase in the Consumer Price 
Index for all Urban Consumers (CPI-U) for the month of October of the 
year in which the amount of each civil penalty was most recently 
established or modified. In the December 14, 2018, Office of Management 
and Budget (OMB) Memorandum for the Heads of Executive Agencies and 
Departments, M-19-04, Implementation of the Penalty Inflation 
Adjustments for 2019, Pursuant to the Federal Civil Penalties Inflation 
Adjustment Act Improvements Act of 2015, OMB published the multiplier 
for the required annual adjustment. The cost-of-living adjustment 
multiplier for 2019, based on the CPI-U for the month of October 2018, 
not seasonally adjusted, is 1.02522. The multiplier is applied to each 
applicable penalty amount that was updated and published for FY 2018 
and is rounded to the nearest dollar.
    Using the 2019 multiplier, HHS adjusted all its applicable monetary 
penalties in 45 CFR 102.3. In addition to the adjustment, a technical 
error for an incorrect citation in the description of 21 U.S.C. 
333(f)(3)(A) was identified and is corrected below.

III. Statutory and Executive Order Reviews

    The 2015 Act requires federal agencies to publish annual penalty 
inflation adjustments notwithstanding section 553 of the Administrative 
Procedure Act (APA).
    Section 4(a) of the 2015 Act directs federal agencies to publish 
annual adjustments no later than January 15th of each year thereafter. 
In accordance with section 553 of the APA, most rules are subject to 
notice and comment and are effective no earlier than 30 days after 
publication in the Federal Register. However, section 4(b)(2) of the 
2015 Act provides that each agency shall make the annual inflation 
adjustments ``notwithstanding section 553'' of the APA. According to 
OMB's Memorandum M-19-04, the phrase ``notwithstanding section 553'' in 
section 4(b)(2) of the 2015 Act means that ``the public procedure the 
APA

[[Page 59550]]

generally requires (i.e., notice, an opportunity for comment, and a 
delay in effective date) is not required for agencies to issue 
regulations implementing the annual adjustment.''
    Consistent with the language of the 2015 Act and OMB's 
implementation guidance, this rule is not subject to notice and an 
opportunity for public comment and will be effective immediately upon 
publication.
    Pursuant to OMB Memorandum M-19-04, HHS has determined that the 
annual inflation adjustment to the civil monetary penalties in its 
regulations does not trigger any requirements under procedural statutes 
and Executive Orders that govern rulemaking procedures.

IV. Effective Date

    This rule is effective November 5, 2019. The adjusted civil 
monetary penalty amounts apply to penalties assessed on or after 
November 5, 2019, if the violation occurred on or after November 2, 
2015. If the violation occurred prior to November 2, 2015, or a penalty 
was assessed prior to September 6, 2016, the pre-adjustment civil 
penalty amounts in effect prior to September 6, 2016, will apply.

List of Subjects in 45 CFR Part 102

    Administrative practice and procedure, Penalties.

    For reasons discussed in the preamble, the Department of Health and 
Human Services amends 45 CFR part 102 as follows:

PART 102--ADJUSTMENT OF CIVIL MONETARY PENALTIES FOR INFLATION

0
1. The authority citation for part 102 continues to read as follows:

    Authority: Public Law 101-410, Sec. 701 of Public Law 114-74, 31 
U.S.C. 3801-3812.


0
2. Amend Sec.  102.3 by revising the table to read as follows:


Sec.  102.3  Penalty adjustment and table.

* * * * *

                                   Civil Monetary Penalty Authorities Administered by HHS Agencies and Penalty Amounts
                                                              [Effective November 5, 2019]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                     Date of
                                                                                                                       last         2018         2019
                                                                                                                   statutorily    Maximum      Maximum
                U.S.C.                           CFR \1\                HHS agency            Description \2\      established    adjusted     adjusted
                                                                                                                     penalty    penalty ($)  penalty ($)
                                                                                                                    figure \3\                   \4\
--------------------------------------------------------------------------------------------------------------------------------------------------------
21 U.S.C.:
    333(b)(2)(A)......................  .........................  FDA.................  Penalty for violations           2018      102,606      105,194
                                                                                          related to drug samples
                                                                                          resulting in a
                                                                                          conviction of any
                                                                                          representative of
                                                                                          manufacturer or
                                                                                          distributor in any 10-
                                                                                          year period.
    333(b)(2)(B)......................  .........................  FDA.................  Penalty for violation            2018    2,052,107    2,103,861
                                                                                          related to drug samples
                                                                                          resulting in a
                                                                                          conviction of any
                                                                                          representative of
                                                                                          manufacturer or
                                                                                          distributor after the
                                                                                          second conviction in
                                                                                          any 10-yr period.
    333(b)(3).........................  .........................  FDA.................  Penalty for failure to           2018      205,211      210,386
                                                                                          make a report required
                                                                                          by 21 U.S.C.
                                                                                          353(d)(3)(E) relating
                                                                                          to drug samples.
    333(f)(1)(A)......................  .........................  FDA.................  Penalty for any person           2018       27,714       28,413
                                                                                          who violates a
                                                                                          requirement related to
                                                                                          devices for each such
                                                                                          violation.
                                                                                         Penalty for aggregate of         2018    1,847,663    1,894,261
                                                                                          all violations related
                                                                                          to devices in a single
                                                                                          proceeding.
    333(f)(2)(A)......................  .........................  FDA.................  Penalty for any                  2018       77,910       79,875
                                                                                          individual who
                                                                                          introduces or delivers
                                                                                          for introduction into
                                                                                          interstate commerce
                                                                                          food that is
                                                                                          adulterated per 21
                                                                                          U.S.C. 342(a)(2)(B) or
                                                                                          any individual who does
                                                                                          not comply with a
                                                                                          recall order under 21
                                                                                          U.S.C. 350l.
                                                                                         Penalty in the case of           2018      389,550      399,374
                                                                                          any other person other
                                                                                          than an individual) for
                                                                                          such introduction or
                                                                                          delivery of adulterated
                                                                                          food.
                                                                                         Penalty for aggregate of         2018      779,098      798,747
                                                                                          all such violations
                                                                                          related to adulterated
                                                                                          food adjudicated in a
                                                                                          single proceeding.
    333(f)(3)(A)......................  .........................  FDA.................  Penalty for all                  2018       11,805       12,103
                                                                                          violations adjudicated
                                                                                          in a single proceeding
                                                                                          for any person who
                                                                                          violates 21 U.S.C.
                                                                                          331(jj) by failing to
                                                                                          submit the
                                                                                          certification required
                                                                                          by 42 U.S.C.
                                                                                          282(j)(5)(B) or
                                                                                          knowingly submitting a
                                                                                          false certification; by
                                                                                          failing to submit
                                                                                          clinical trial
                                                                                          information under 42
                                                                                          U.S.C. 282(j); or by
                                                                                          submitting clinical
                                                                                          trial information under
                                                                                          42 U.S.C. 282(j) that
                                                                                          is false or misleading
                                                                                          in any particular under
                                                                                          42 U.S.C. 282(j)(5)(D).
    333(f)(3)(B)......................  .........................  FDA.................  Penalty for each day any         2018       11,805       12,103
                                                                                          above violation is not
                                                                                          corrected after a 30-
                                                                                          day period following
                                                                                          notification until the
                                                                                          violation is corrected.
    333(f)(4)(A)(i)...................  .........................  FDA.................  Penalty for any                  2018      295,142      302,585
                                                                                          responsible person that
                                                                                          violates a requirement
                                                                                          of 21 U.S.C. 355(o)
                                                                                          (post-marketing
                                                                                          studies, clinical
                                                                                          trials, labeling), 21
                                                                                          U.S.C. 355(p) (risk
                                                                                          evaluation and
                                                                                          mitigation (REMS)), or
                                                                                          21 U.S.C. 355-1 (REMS).

[[Page 59551]]

 
                                                                                         Penalty for aggregate of         2018    1,180,566    1,210,340
                                                                                          all such above
                                                                                          violations in a single
                                                                                          proceeding.
    333(f)(4)(A)(ii)..................  .........................  FDA.................  Penalty for REMS                 2018      295,142      302,585
                                                                                          violation that
                                                                                          continues after written
                                                                                          notice to the
                                                                                          responsible person for
                                                                                          the first 30-day period
                                                                                          (or any portion
                                                                                          thereof) the
                                                                                          responsible person
                                                                                          continues to be in
                                                                                          violation.
                                                                                         Penalty for REMS                 2018    1,180,566    1,210,340
                                                                                          violation that
                                                                                          continues after written
                                                                                          notice to responsible
                                                                                          person doubles for
                                                                                          every 30-day period
                                                                                          thereafter the
                                                                                          violation continues,
                                                                                          but may not exceed
                                                                                          penalty amount for any
                                                                                          30-day period.
                                                                                         Penalty for aggregate of         2018   11,805,665   12,103,404
                                                                                          all such above
                                                                                          violations adjudicated
                                                                                          in a single proceeding.
    333(f)(9)(A)......................  .........................  FDA.................  Penalty for any person           2018       17,115       17,547
                                                                                          who violates a
                                                                                          requirement which
                                                                                          relates to tobacco
                                                                                          products for each such
                                                                                          violation.
                                                                                         Penalty for aggregate of         2018    1,141,021    1,169,798
                                                                                          all such violations of
                                                                                          tobacco product
                                                                                          requirement adjudicated
                                                                                          in a single proceeding.
    333(f)(9)(B)(i)(I)................  .........................  FDA.................  Penalty per violation            2018      285,256      292,450
                                                                                          related to violations
                                                                                          of tobacco requirements.
                                                                                         Penalty for aggregate of         2018    1,141,021    1,169,798
                                                                                          all such violations of
                                                                                          tobacco product
                                                                                          requirements
                                                                                          adjudicated in a single
                                                                                          proceeding.
    333(f)(9)(B)(i)(II)...............  .........................  FDA.................  Penalty in the case of a         2018      285,256      292,450
                                                                                          violation of tobacco
                                                                                          product requirements
                                                                                          that continues after
                                                                                          written notice to such
                                                                                          person, for the first
                                                                                          30-day period (or any
                                                                                          portion thereof) the
                                                                                          person continues to be
                                                                                          in violation.
                                                                                         Penalty for violation of         2018    1,141,021    1,169,798
                                                                                          tobacco product
                                                                                          requirements that
                                                                                          continues after written
                                                                                          notice to such person
                                                                                          shall double for every
                                                                                          30-day period
                                                                                          thereafter the
                                                                                          violation continues,
                                                                                          but may not exceed
                                                                                          penalty amount for any
                                                                                          30-day period.
                                                                                         Penalty for aggregate of         2018   11,410,217   11,697,983
                                                                                          all such violations
                                                                                          related to tobacco
                                                                                          product requirements
                                                                                          adjudicated in a single
                                                                                          proceeding.
    333(f)(9)(B)(ii)(I)...............  .........................  FDA.................  Penalty for any person           2018      285,256      292,450
                                                                                          who either does not
                                                                                          conduct post-market
                                                                                          surveillance and
                                                                                          studies to determine
                                                                                          impact of a modified
                                                                                          risk tobacco product
                                                                                          for which the HHS
                                                                                          Secretary has provided
                                                                                          them an order to sell,
                                                                                          or who does not submit
                                                                                          a protocol to the HHS
                                                                                          Secretary after being
                                                                                          notified of a
                                                                                          requirement to conduct
                                                                                          post-market
                                                                                          surveillance of such
                                                                                          tobacco products.
                                                                                         Penalty for aggregate of         2018    1,141,021    1,169,798
                                                                                          for all such above
                                                                                          violations adjudicated
                                                                                          in a single proceeding.
    333(f)(9)(B)(ii)(II)..............  .........................  FDA.................  Penalty for violation of         2018      285,256      292,450
                                                                                          modified risk tobacco
                                                                                          product post-market
                                                                                          surveillance that
                                                                                          continues after written
                                                                                          notice to such person
                                                                                          for the first 30-day
                                                                                          period (or any portion
                                                                                          thereof) that the
                                                                                          person continues to be
                                                                                          in violation.
                                                                                         Penalty for post-notice          2018    1,141,021    1,169,798
                                                                                          violation of modified
                                                                                          risk tobacco product
                                                                                          post-market
                                                                                          surveillance shall
                                                                                          double for every 30-day
                                                                                          period thereafter that
                                                                                          the tobacco product
                                                                                          requirement violation
                                                                                          continues for any 30-
                                                                                          day period, but may not
                                                                                          exceed penalty amount
                                                                                          for any 30-day period.
                                                                                         Penalty for aggregate            2018   11,410,217   11,697,983
                                                                                          above tobacco product
                                                                                          requirement violations
                                                                                          adjudicated in a single
                                                                                          proceeding.
    333(g)(1).........................  .........................  FDA.................  Penalty for any person           2018      295,142      302,585
                                                                                          who disseminates or
                                                                                          causes another party to
                                                                                          disseminate a direct-to-
                                                                                          consumer advertisement
                                                                                          that is false or
                                                                                          misleading for the
                                                                                          first such violation in
                                                                                          any 3-year period.

[[Page 59552]]

 
                                                                                         Penalty for each                 2018      590,284      605,171
                                                                                          subsequent above
                                                                                          violation in any 3-year
                                                                                          period.
    333 note..........................  .........................  FDA.................  Penalty to be applied            2018    284.69439          292
                                                                                          for violations of
                                                                                          restrictions on the
                                                                                          sale or distribution of
                                                                                          tobacco products
                                                                                          promulgated under 21
                                                                                          U.S.C. 387f(d) (e.g.,
                                                                                          violations of
                                                                                          regulations in 21 CFR
                                                                                          part 1140) with respect
                                                                                          to a retailer with an
                                                                                          approved training
                                                                                          program in the case of
                                                                                          a second regulation
                                                                                          violation within a 12-
                                                                                          month period.
                                                                                         Penalty in the case of a         2018    570.40919          584
                                                                                          third tobacco product
                                                                                          regulation violation
                                                                                          within a 24-month
                                                                                          period.
                                                                                         Penalty in the case of a         2018        2,282        2,340
                                                                                          fourth tobacco product
                                                                                          regulation violation
                                                                                          within a 24-month
                                                                                          period.
                                                                                         Penalty in the case of a         2018        5,705        5,849
                                                                                          fifth tobacco product
                                                                                          regulation violation
                                                                                          within a 36-month
                                                                                          period.
                                                                                         Penalty in the case of a         2018       11,410       11,698
                                                                                          sixth or subsequent
                                                                                          tobacco product
                                                                                          regulation violation
                                                                                          within a 48-month
                                                                                          period as determined on
                                                                                          a case-by-case basis.
                                                                                         Penalty to be applied            2018    284.69439          292
                                                                                          for violations of
                                                                                          restrictions on the
                                                                                          sale or distribution of
                                                                                          tobacco products
                                                                                          promulgated under 21
                                                                                          U.S.C. 387f(d) (e.g.,
                                                                                          violations of
                                                                                          regulations in 21 CFR
                                                                                          part 1140) with respect
                                                                                          to a retailer that does
                                                                                          not have an approved
                                                                                          training program in the
                                                                                          case of the first
                                                                                          regulation violation.
                                                                                         Penalty in the case of a         2018    570.40919          584
                                                                                          second tobacco product
                                                                                          regulation violation
                                                                                          within a 12-month
                                                                                          period.
                                                                                         Penalty in the case of a         2018        1,141        1,170
                                                                                          third tobacco product
                                                                                          regulation violation
                                                                                          within a 24-month
                                                                                          period.
                                                                                         Penalty in the case of a         2018        2,282        2,340
                                                                                          fourth tobacco product
                                                                                          regulation violation
                                                                                          within a 24-month
                                                                                          period.
                                                                                         Penalty in the case of a         2018        5,705        5,849
                                                                                          fifth tobacco product
                                                                                          regulation violation
                                                                                          within a 36-month
                                                                                          period.
                                                                                         Penalty in the case of a         2018        5,705        5,849
                                                                                          fifth tobacco product
                                                                                          regulation violation
                                                                                          within a 36-month
                                                                                          period.
                                                                                         Penalty in the case of a         2018       11,410       11,698
                                                                                          sixth or subsequent
                                                                                          tobacco product
                                                                                          regulation violation
                                                                                          within a 48-month
                                                                                          period as determined on
                                                                                          a case-by-case basis.
    335b(a)...........................  .........................  FDA.................  Penalty for each                 2018      434,878      445,846
                                                                                          violation for any
                                                                                          individual who made a
                                                                                          false statement or
                                                                                          misrepresentation of a
                                                                                          material fact, bribed,
                                                                                          destroyed, altered,
                                                                                          removed, or secreted,
                                                                                          or procured the
                                                                                          destruction,
                                                                                          alteration, removal, or
                                                                                          secretion of, any
                                                                                          material document,
                                                                                          failed to disclose a
                                                                                          material fact,
                                                                                          obstructed an
                                                                                          investigation, employed
                                                                                          a consultant who was
                                                                                          debarred, debarred
                                                                                          individual provided
                                                                                          consultant services.
                                                                                         Penalty in the case of           2018    1,739,513    1,783,384
                                                                                          any other person (other
                                                                                          than an individual) per
                                                                                          above violation..
    360pp(b)(1).......................  .........................  FDA.................  Penalty for any person           2018        2,852        2,924
                                                                                          who violates any such
                                                                                          requirements for
                                                                                          electronic products,
                                                                                          with each unlawful act
                                                                                          or omission
                                                                                          constituting a separate
                                                                                          violation.
                                                                                         Penalty imposed for any          2018      972,285      996,806
                                                                                          related series of
                                                                                          violations of
                                                                                          requirements relating
                                                                                          to electronic products..
42 U.S.C:
    262(d)............................  .........................  FDA.................  Penalty per day for              2018      223,629      229,269
                                                                                          violation of order of
                                                                                          recall of biological
                                                                                          product presenting
                                                                                          imminent or substantial
                                                                                          hazard.

[[Page 59553]]

 
    263b(h)(3)........................  .........................  FDA.................  Penalty for failure to           2018       17,395       17,834
                                                                                          obtain a mammography
                                                                                          certificate as required.
    300aa-28(b)(1)....................  .........................  FDA.................  Penalty per occurrence           2018      223,629      229,269
                                                                                          for any vaccine
                                                                                          manufacturer that
                                                                                          intentionally destroys,
                                                                                          alters, falsifies, or
                                                                                          conceals any record or
                                                                                          report required.
    256b(d)(1)(B)(vi).................  .........................  HRSA................  Penalty for each                 2018        5,639        5,781
                                                                                          instance of
                                                                                          overcharging a 340B
                                                                                          covered entity.
    299c-(3)(d).......................  .........................  AHRQ................  Penalty for an                   2018       14,664       15,034
                                                                                          establishment or person
                                                                                          supplying information
                                                                                          obtained in the course
                                                                                          of activities for any
                                                                                          purpose other than the
                                                                                          purpose for which it
                                                                                          was supplied.
    653(l)(2).........................  45 CFR 303.21(f).........  ACF.................  Penalty for Misuse of            2018        1,504        1,542
                                                                                          Information in the
                                                                                          National Directory of
                                                                                          New Hires.
    262a(i)(1)........................  42 CFR 1003.910..........  OIG.................  Penalty for each                 2018      340,130      348,708
                                                                                          individual who violates
                                                                                          safety and security
                                                                                          procedures related to
                                                                                          handling dangerous
                                                                                          biological agents and
                                                                                          toxins.
                                                                                         Penalty for any other            2018      680,262      697,418
                                                                                          person who violates
                                                                                          safety and security
                                                                                          procedures related to
                                                                                          handling dangerous
                                                                                          biological agents and
                                                                                          toxins.
    300jj-51..........................  .........................  OIG.................  Penalty per violation            2018    1,037,104    1,063,260
                                                                                          for committing
                                                                                          information blocking.
    1320a-7a(a).......................  42 CFR 1003.210(a)(1)....  OIG.................  Penalty for knowingly            2018       20,000       20,504
                                                                                          presenting or causing
                                                                                          to be presented to an
                                                                                          officer, employee, or
                                                                                          agent of the United
                                                                                          States a false claim.
                                                                                         Penalty for knowingly            2018       20,000       20,504
                                                                                          presenting or causing
                                                                                          to be presented a
                                                                                          request for payment
                                                                                          which violates the
                                                                                          terms of an assignment,
                                                                                          agreement, or PPS
                                                                                          agreement.
                                        42 CFR 1003.210(a)(2)....  ....................  Penalty for knowingly            2018       30,000       30,757
                                                                                          giving or causing to be
                                                                                          presented to a
                                                                                          participating provider
                                                                                          or supplier false or
                                                                                          misleading information
                                                                                          that could reasonably
                                                                                          be expected to
                                                                                          influence a discharge
                                                                                          decision.
                                        42 CFR 1003.210(a)(3)....  ....................  Penalty for an excluded          2018       20,000       20,504
                                                                                          party retaining
                                                                                          ownership or control
                                                                                          interest in a
                                                                                          participating entity.
                                        42 CFR 1003.1010.........  ....................  Penalty for remuneration         2018       20,000       20,504
                                                                                          offered to induce
                                                                                          program beneficiaries
                                                                                          to use particular
                                                                                          providers,
                                                                                          practitioners, or
                                                                                          suppliers.
                                        42 CFR 1003.210(a)(4)....  ....................  Penalty for employing or         2018       20,000       20,504
                                                                                          contracting with an
                                                                                          excluded individual.
                                        42 CFR 1003.310(a)(3)....  ....................  Penalty for knowing and          2018      100,000      102,522
                                                                                          willful solicitation,
                                                                                          receipt, offer, or
                                                                                          payment of remuneration
                                                                                          for referring an
                                                                                          individual for a
                                                                                          service or for
                                                                                          purchasing, leasing, or
                                                                                          ordering an item to be
                                                                                          paid for by a Federal
                                                                                          health care program.
                                        42 CFR 1003.210(a)(1)....  ....................  Penalty for ordering or          2018       20,000       20,504
                                                                                          prescribing medical or
                                                                                          other item or service
                                                                                          during a period in
                                                                                          which the person was
                                                                                          excluded.
                                        42 CFR 1003.210(a)(6)....  ....................  Penalty for knowingly            2018      100,000      102,522
                                                                                          making or causing to be
                                                                                          made a false statement,
                                                                                          omission or
                                                                                          misrepresentation of a
                                                                                          material fact in any
                                                                                          application, bid, or
                                                                                          contract to participate
                                                                                          or enroll as a provider
                                                                                          or supplier.
                                        42 CFR 1003.210(a)(8)....  ....................  Penalty for knowing of           2018       20,000       20,504
                                                                                          an overpayment and
                                                                                          failing to report and
                                                                                          return.
                                        42 CFR 1003.210(a)(7)....  ....................  Penalty for making or            2018      100,000      102,522
                                                                                          using a false record or
                                                                                          statement that is
                                                                                          material to a false or
                                                                                          fraudulent claim.
                                        42 CFR 1003.210(a)(9)....  ....................  Penalty for failure to           2018       30,000       30,757
                                                                                          grant timely access to
                                                                                          HHS OIG for audits,
                                                                                          investigations,
                                                                                          evaluations, and other
                                                                                          statutory functions of
                                                                                          HHS OIG.
    1320a-7a(b).......................  .........................  OIG.................  Penalty for payments by          2018        5,000        5,126
                                                                                          a hospital or critical
                                                                                          access hospital to
                                                                                          induce a physician to
                                                                                          reduce or limit
                                                                                          services to individuals
                                                                                          under direct care of
                                                                                          physician or who are
                                                                                          entitled to certain
                                                                                          medical assistance
                                                                                          benefits

[[Page 59554]]

 
                                                                                         Penalty for physicians           2018        5,000        5,126
                                                                                          who knowingly receive
                                                                                          payments from a
                                                                                          hospital or critical
                                                                                          access hospital to
                                                                                          induce such physician
                                                                                          to reduce or limit
                                                                                          services to individuals
                                                                                          under direct care of
                                                                                          physician or who are
                                                                                          entitled to certain
                                                                                          medical assistance
                                                                                          benefits.
                                        42 CFR 1003.210(a)(10)...  ....................  Penalty for a physician          2018       10,000       10,252
                                                                                          who executes a document
                                                                                          that falsely certifies
                                                                                          home health needs for
                                                                                          Medicare beneficiaries
    1320a-7a(o).......................  .........................  OIG.................  Penalty for knowingly            2016       10,000       10,461
                                                                                          presenting or causing
                                                                                          to be presented a false
                                                                                          or fraudulent specified
                                                                                          claim under a grant,
                                                                                          contract, or other
                                                                                          agreement for which the
                                                                                          Secretary provides
                                                                                          funding
                                                                                         Knowingly makes, uses,           2016       50,000       52,308
                                                                                          or causes to be made or
                                                                                          used any false
                                                                                          statement, omission, or
                                                                                          misrepresentation of a
                                                                                          material fact in any
                                                                                          application, proposal,
                                                                                          bid, progress report,
                                                                                          or other document
                                                                                          required to directly or
                                                                                          indirectly receive or
                                                                                          retain funds provided
                                                                                          pursuant to grant,
                                                                                          contract, or other
                                                                                          agreement
                                                                                         Knowingly makes, uses,           2016       50,000       52,308
                                                                                          or causes to be made or
                                                                                          used, a false record or
                                                                                          statement material to a
                                                                                          false or fraudulent
                                                                                          specified claim under
                                                                                          grant, contract, or
                                                                                          other agreement.
                                                                                         Knowingly makes, uses,           2016     * 50,000    ** 52,308
                                                                                          or causes to be made or
                                                                                          used, a false record or
                                                                                          statement material to
                                                                                          an obligation to pay or
                                                                                          transmit funds or
                                                                                          property with respect
                                                                                          to grant, contract, or
                                                                                          other agreement, or
                                                                                          knowingly conceals or
                                                                                          improperly avoids or
                                                                                          decreases any such
                                                                                          obligation..
                                                                                         Fails to grant timely            2016       15,000       15,692
                                                                                          access, upon reasonable
                                                                                          request, to the I.G.
                                                                                          for purposes of audits,
                                                                                          investigations,
                                                                                          evaluations, or other
                                                                                          statutory functions of
                                                                                          I.G. in matters
                                                                                          involving grants,
                                                                                          contracts, or other
                                                                                          agreements..
    1320a-7e(b)(6)(A).................  42 CFR 1003.810..........  OIG.................  Penalty for failure to           2018       38,159       39,121
                                                                                          report any final
                                                                                          adverse action taken
                                                                                          against a health care
                                                                                          provider, supplier, or
                                                                                          practitioner.
    1320b-10(b)(1)....................  42 CFR 1003.610(a).......  OIG.................  Penalty for the misuse           2018       10,260       10,519
                                                                                          of words, symbols, or
                                                                                          emblems in
                                                                                          communications in a
                                                                                          manner in which a
                                                                                          person could falsely
                                                                                          construe that such item
                                                                                          is approved, endorsed,
                                                                                          or authorized by HHS.
    1320b-10(b)(2)....................  42 CFR 1003.610(a).......  OIG.................  Penalty for the misuse           2018       51,302       52,596
                                                                                          of words, symbols, or
                                                                                          emblems in a broadcast
                                                                                          or telecast in a manner
                                                                                          in which a person could
                                                                                          falsely construe that
                                                                                          such item is approved,
                                                                                          endorsed, or authorized
                                                                                          by HHS.
    1395i-3(b)(3)(B)(ii)(1)...........  42 CFR 1003.210(a)(11)...  OIG.................  Penalty for                      2018        2,140        2,194
                                                                                          certification of a
                                                                                          false statement in
                                                                                          assessment of
                                                                                          functional capacity of
                                                                                          a Skilled Nursing
                                                                                          Facility resident
                                                                                          assessment.
    1395i-3(b)(3)(B)(ii)(2)...........  42 CFR 1003.210(a)(11)...  OIG.................  Penalty for causing              2018       10,697       10,967
                                                                                          another to certify or
                                                                                          make a false statement
                                                                                          in assessment of
                                                                                          functional capacity of
                                                                                          a Skilled Nursing
                                                                                          Facility resident
                                                                                          assessment.
    1395i-3(g)(2)(A)..................  42 CFR 1003.1310.........  OIG.................  Penalty for any                  2018        4,280        4,388
                                                                                          individual who notifies
                                                                                          or causes to be
                                                                                          notified a Skilled
                                                                                          Nursing Facility of the
                                                                                          time or date on which a
                                                                                          survey is to be
                                                                                          conducted.
    1395w-27(g)(2)(A).................  42 CFR 1003.410..........  OIG.................  Penalty for a Medicare           2018       38,954       39,936
                                                                                          Advantage organization
                                                                                          that substantially
                                                                                          fails to provide
                                                                                          medically necessary,
                                                                                          required items and
                                                                                          services.
                                                                                         Penalty for a Medicare           2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          that charges excessive
                                                                                          premiums.
                                                                                         Penalty for a Medicare           2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          that improperly expels
                                                                                          or refuses to reenroll
                                                                                          a beneficiary.

[[Page 59555]]

 
                                                                                         Penalty for a Medicare           2018      152,638      156,488
                                                                                          Advantage organization
                                                                                          that engages in
                                                                                          practice that would
                                                                                          reasonably be expected
                                                                                          to have the effect of
                                                                                          denying or discouraging
                                                                                          enrollment.
                                                                                         Penalty per individual           2018       22,896       23,473
                                                                                          who does not enroll as
                                                                                          a result of a Medicare
                                                                                          Advantage
                                                                                          organization's practice
                                                                                          that would reasonably
                                                                                          be expected to have the
                                                                                          effect of denying or
                                                                                          discouraging enrollment.
                                                                                         Penalty for a Medicare           2018      152,638      156,488
                                                                                          Advantage organization
                                                                                          misrepresenting or
                                                                                          falsifying information
                                                                                          to Secretary.
                                                                                         Penalty for a Medicare           2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          misrepresenting or
                                                                                          falsifying information
                                                                                          to individual or other
                                                                                          entity.
                                                                                         Penalty for Medicare             2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          interfering with
                                                                                          provider's advice to
                                                                                          enrollee and non-MCO
                                                                                          affiliated providers
                                                                                          that balance bill
                                                                                          enrollees.
                                                                                         Penalty for a Medicare           2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          that employs or
                                                                                          contracts with excluded
                                                                                          individual or entity.
                                                                                         Penalty for a Medicare           2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          enrolling an individual
                                                                                          in without prior
                                                                                          written consent.
                                                                                         Penalty for a Medicare           2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          transferring an
                                                                                          enrollee to another
                                                                                          plan without consent or
                                                                                          solely for the purpose
                                                                                          of earning a commission.
                                                                                         Penalty for a Medicare           2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          failing to comply with
                                                                                          marketing restrictions
                                                                                          or applicable
                                                                                          implementing
                                                                                          regulations or guidance.
                                                                                         Penalty for a Medicare           2018       38,159       39,121
                                                                                          Advantage organization
                                                                                          employing or
                                                                                          contracting with an
                                                                                          individual or entity
                                                                                          who violates 1395w-
                                                                                          27(g)(1)(A)-(J).
    1395w-141(i)(3)...................  .........................  OIG.................  Penalty for a                    2018       13,333       13,669
                                                                                          prescription drug card
                                                                                          sponsor that falsifies
                                                                                          or misrepresents
                                                                                          marketing materials,
                                                                                          overcharges program
                                                                                          enrollees, or misuse
                                                                                          transitional assistance
                                                                                          funds.
    1395cc(g).........................  42 CFR 1003.210(a)(5)....  OIG.................  Penalty for improper             2018        5,186        5,317
                                                                                          billing by Hospitals,
                                                                                          Critical Access
                                                                                          Hospitals, or Skilled
                                                                                          Nursing Facilities.
    1395dd(d)(1)......................  42 CFR 1003.510..........  OIG.................  Penalty for a hospital           2018      106,965      109,663
                                                                                          with 100 beds or more
                                                                                          or responsible
                                                                                          physician dumping
                                                                                          patients needing
                                                                                          emergency medical care.
                                                                                         Penalty for a hospital           2018       53,484       54,833
                                                                                          with less than 100 beds
                                                                                          dumping patients
                                                                                          needing emergency
                                                                                          medical care.
    1395mm(i)(6)(B)(i)................  42 CFR 1003.410..........  OIG.................  Penalty for a HMO or             2018       53,484       54,833
                                                                                          competitive plan if
                                                                                          such plan substantially
                                                                                          fails to provide
                                                                                          medically necessary,
                                                                                          required items or
                                                                                          services.
                                                                                         Penalty for HMOs/                2018       53,484       54,833
                                                                                          competitive medical
                                                                                          plans that charge
                                                                                          premiums in excess of
                                                                                          permitted amounts.
                                                                                         Penalty for a HMO or             2018       53,484       54,833
                                                                                          competitive medical
                                                                                          plan that expels or
                                                                                          refuses to reenroll an
                                                                                          individual per
                                                                                          prescribed conditions.
                                                                                         Penalty for a HMO or             2018      213,932      219,327
                                                                                          competitive medical
                                                                                          plan that implements
                                                                                          practices to discourage
                                                                                          enrollment of
                                                                                          individuals needing
                                                                                          services in future.
                                                                                         Penalty per individual           2018       30,782       31,558
                                                                                          not enrolled in a plan
                                                                                          as a result of a HMO or
                                                                                          competitive medical
                                                                                          plan that implements
                                                                                          practices to discourage
                                                                                          enrollment of
                                                                                          individuals needing
                                                                                          services in the future.
                                                                                         Penalty for a HMO or             2018      213,932      219,327
                                                                                          competitive medical
                                                                                          plan that misrepresents
                                                                                          or falsifies
                                                                                          information to the
                                                                                          Secretary.

[[Page 59556]]

 
                                                                                         Penalty for a HMO or             2018       53,484       54,833
                                                                                          competitive medical
                                                                                          plan that misrepresents
                                                                                          or falsifies
                                                                                          information to an
                                                                                          individual or any other
                                                                                          entity.
                                                                                         Penalty for failure by           2018       53,484       54,833
                                                                                          HMO or competitive
                                                                                          medical plan to assure
                                                                                          prompt payment of
                                                                                          Medicare risk sharing
                                                                                          contracts or incentive
                                                                                          plan provisions.
                                                                                         Penalty for HMO that             2018       49,096       50,334
                                                                                          employs or contracts
                                                                                          with excluded
                                                                                          individual or entity.
    1395nn(g)(3)......................  42 CFR 1003.310..........  OIG.................  Penalty for submitting           2018       24,748       25,372
                                                                                          or causing to be
                                                                                          submitted claims in
                                                                                          violation of the Stark
                                                                                          Law's restrictions on
                                                                                          physician self-
                                                                                          referrals.
    1395nn(g)(4)......................  42 CFR 1003.310..........  OIG.................  Penalty for                      2018      164,992      169,153
                                                                                          circumventing Stark
                                                                                          Law's restrictions on
                                                                                          physician self-
                                                                                          referrals.
    1395ss(d)(1)......................  42 CFR 1003.1110.........  OIG.................  Penalty for a material           2018       10,260       10,519
                                                                                          misrepresentation
                                                                                          regarding Medigap
                                                                                          compliance policies.
    1395ss(d)(2)......................  42 CFR 1003.1110.........  OIG.................  Penalty for selling              2018       10,260       10,519
                                                                                          Medigap policy under
                                                                                          false pretense.
    1395ss(d)(3)(A)(ii)...............  42 CFR 1003.1110.........  OIG.................  Penalty for an issuer            2018       46,192       47,357
                                                                                          that sells health
                                                                                          insurance policy that
                                                                                          duplicates benefits.
                                                                                         Penalty for someone              2018       27,714       28,413
                                                                                          other than issuer that
                                                                                          sells health insurance
                                                                                          that duplicates
                                                                                          benefits.
    1395ss(d)(4)(A)...................  42 CFR 1003.1110.........  OIG.................  Penalty for using mail           2018       10,260       10,519
                                                                                          to sell a non-approved
                                                                                          Medigap insurance
                                                                                          policy.
    1396b(m)(5)(B)(i).................  42 CFR 1003.410..........  OIG.................  Penalty for a Medicaid           2018       51,302       52,596
                                                                                          MCO that substantially
                                                                                          fails to provide
                                                                                          medically necessary,
                                                                                          required items or
                                                                                          services.
                                                                                         Penalty for a Medicaid           2018       51,302       52,596
                                                                                          MCO that charges
                                                                                          excessive premiums.
                                                                                         Penalty for a Medicaid           2018      205,211      210,386
                                                                                          MCO that improperly
                                                                                          expels or refuses to
                                                                                          reenroll a beneficiary.
                                                                                         Penalty per individual           2018       30,782       31,558
                                                                                          who does not enroll as
                                                                                          a result of a Medicaid
                                                                                          MCO's practice that
                                                                                          would reasonably be
                                                                                          expected to have the
                                                                                          effect of denying or
                                                                                          discouraging enrollment.
                                                                                         Penalty for a Medicaid           2018      205,211      210,386
                                                                                          MCO misrepresenting or
                                                                                          falsifying information
                                                                                          to the Secretary.
                                                                                         Penalty for a Medicaid           2018       51,302       52,596
                                                                                          MCO misrepresenting or
                                                                                          falsifying information
                                                                                          to an individual or
                                                                                          another entity.
                                                                                         Penalty for a Medicaid           2018       46,192       47,357
                                                                                          MCO that fails to
                                                                                          comply with contract
                                                                                          requirements with
                                                                                          respect to physician
                                                                                          incentive plans.
    1396r(b)(3)(B)(ii)(I).............  42 CFR 1003.210(a)(11)...  OIG.................  Penalty for willfully            2018        2,140        2,194
                                                                                          and knowingly
                                                                                          certifying a material
                                                                                          and false statement in
                                                                                          a Skilled Nursing
                                                                                          Facility resident
                                                                                          assessment.
    1396r(b)(3)(B)(ii)(II)............  42 CFR 1003.210(a)(11)...  OIG.................  Penalty for willfully            2018       10,697       10,967
                                                                                          and knowingly causing
                                                                                          another individual to
                                                                                          certify a material and
                                                                                          false statement in a
                                                                                          Skilled Nursing
                                                                                          Facility resident
                                                                                          assessment.
    1396r(g)(2)(A)(i).................  42 CFR 1003.1310.........  OIG.................  Penalty for notifying or         2018        4,280        4,388
                                                                                          causing to be notified
                                                                                          a Skilled Nursing
                                                                                          Facility of the time or
                                                                                          date on which a survey
                                                                                          is to be conducted.
    1396r-8(b)(3)(B)..................  42 CFR 1003.1210.........  OIG.................  Penalty for the knowing          2018      184,767      189,427
                                                                                          provision of false
                                                                                          information or refusing
                                                                                          to provide information
                                                                                          about charges or prices
                                                                                          of a covered outpatient
                                                                                          drug.
    1396r-8(b)(3)(C)(i)...............  42 CFR 1003.1210.........  OIG.................  Penalty per day for              2018       18,477       18,943
                                                                                          failure to timely
                                                                                          provide information by
                                                                                          drug manufacturer with
                                                                                          rebate agreement.
    1396r-8(b)(3)(C)(ii)..............  42 CFR 1003.1210.........  OIG.................  Penalty for knowing              2018      184,767      189,427
                                                                                          provision of false
                                                                                          information by drug
                                                                                          manufacturer with
                                                                                          rebate agreement.
    1396t(i)(3)(A)....................  42 CFR 1003.1310.........  OIG.................  Penalty for notifying            2018        3,695        3,788
                                                                                          home and community-
                                                                                          based providers or
                                                                                          settings of survey.
    11131(c)..........................  42 CFR 1003.810..........  OIG.................  Penalty for failing to           2018       22,363       22,927
                                                                                          report a medical
                                                                                          malpractice claim to
                                                                                          National Practitioner
                                                                                          Data Bank.

[[Page 59557]]

 
    11137(b)(2).......................  42 CFR 1003.810..........  OIG.................  Penalty for breaching            2018       22,363       22,927
                                                                                          confidentiality of
                                                                                          information reported to
                                                                                          National Practitioner
                                                                                          Data Bank.
    299b-22(f)(1).....................  42 CFR 3.404.............  OCR.................  Penalty for violation of         2018       12,383       12,695
                                                                                          confidentiality
                                                                                          provision of the
                                                                                          Patient Safety and
                                                                                          Quality Improvement Act.
                                        45 CFR 160.404(b)(1)(i),   OCR.................  Penalty for each pre-            2018    155.10232          159
                                         (ii).                                            February 18, 2009
                                                                                          violation of the HIPAA
                                                                                          administrative
                                                                                          simplification
                                                                                          provisions.
                                                                                         Calendar Year Cap.......         2018       38,954       39,936
    1320(d)-5(a)......................  45 CFR                     OCR.................  Penalty for each                 2018  ...........  ...........
                                         160.404(b)(2)(i)(A), (B).                        February 18, 2009 or
                                                                                          later violation of a
                                                                                          HIPAA administrative
                                                                                          simplification
                                                                                          provision in which it
                                                                                          is established that the
                                                                                          covered entity or
                                                                                          business associate did
                                                                                          not know and by
                                                                                          exercising reasonable
                                                                                          diligence, would not
                                                                                          have known that the
                                                                                          covered entity or
                                                                                          business associate
                                                                                          violated such a
                                                                                          provision:
                                                                                         Minimum.................         2018    114.28592          117
                                                                                         Maximum.................         2018       57,051       58,490
                                                                                         Calendar Year Cap.......         2018    1,711,533    1,754,698
                                        45 CFR                     OCR.................  Penalty for each                 2018  ...........  ...........
                                         160.404(b)(2)(ii)(A),                            February 18, 2009 or
                                         (B).                                             later violation of a
                                                                                          HIPAA administrative
                                                                                          simplification
                                                                                          provision in which it
                                                                                          is established that the
                                                                                          violation was due to
                                                                                          reasonable cause and
                                                                                          not to willful neglect:
                                                                                         Minimum.................         2018        1,141        1,170
                                                                                         Maximum.................         2018       57,051       58,490
                                                                                         Calendar Year Cap.......         2018    1,711,533    1,754,698
                                        45 CFR                     OCR.................  Penalty for each                 2018  ...........  ...........
                                         160.404(b)(2)(iii)(A),                           February 18, 2009 or
                                         (B).                                             later violation of a
                                                                                          HIPAA administrative
                                                                                          simplification
                                                                                          provision in which it
                                                                                          is established that the
                                                                                          violation was due to
                                                                                          willful neglect and was
                                                                                          corrected during the 30-
                                                                                          day period beginning on
                                                                                          the first date the
                                                                                          covered entity or
                                                                                          business associate
                                                                                          knew, or, by exercising
                                                                                          reasonable diligence,
                                                                                          would have known that
                                                                                          the violation occurred:
                                                                                         Minimum.................         2018       11,410       11,698
                                                                                         Maximum.................         2018       57,051       58,490
                                                                                         Calendar Year Cap.......         2018    1,711,533    1,754,698
                                        45 CFR                     OCR.................  Penalty for each                 2018  ...........  ...........
                                         160.404(b)(2)(iv)(A),                            February 18, 2009 or
                                         (B).                                             later violation of a
                                                                                          HIPAA administrative
                                                                                          simplification
                                                                                          provision in which it
                                                                                          is established that the
                                                                                          violation was due to
                                                                                          willful neglect and was
                                                                                          not corrected during
                                                                                          the 30-day period
                                                                                          beginning on the first
                                                                                          date the covered entity
                                                                                          or business associate
                                                                                          knew, or by exercising
                                                                                          reasonable diligence,
                                                                                          would have known that
                                                                                          the violation occurred:
                                                                                         Minimum.................         2018       57,051       58,490
                                                                                         Maximum.................         2018    1,711,533    1,754,698
                                                                                         Calendar Year Cap.......         2018    1,711,533    1,754,698
    263a(h)(2)(B) & 1395w-              42 CFR 493.1834(d)(2)(i).  CMS.................  Penalty for a clinical           2018  ...........  ...........
     2(b)(2)(A)(ii).                                                                      laboratory's failure to
                                                                                          meet participation and
                                                                                          certification
                                                                                          requirements and poses
                                                                                          immediate jeopardy:
                                                                                         Minimum.................         2018        6,259        6,417
                                                                                         Maximum.................         2018       20,521       21,039
                                        42 CFR 493.1834(d)(2)(ii)  CMS.................  Penalty for a clinical           2018  ...........  ...........
                                                                                          laboratory's failure to
                                                                                          meet participation and
                                                                                          certification
                                                                                          requirements and the
                                                                                          failure does not pose
                                                                                          immediate jeopardy:
                                                                                         Minimum.................         2018          103          106
                                                                                         Maximum.................         2018        6,156        6,311
    300gg-15(f).......................  45 CFR 147.200(e)........  CMS.................  Failure to provide the           2018        1,128        1,156
                                                                                          Summary of Benefits and
                                                                                          Coverage.
    300gg-18..........................  45 CFR 158.606...........  CMS.................  Penalty for violations           2018          113          116
                                                                                          of regulations related
                                                                                          to the medical loss
                                                                                          ratio reporting and
                                                                                          rebating.

[[Page 59558]]

 
    1320a-7h(b)(1)....................  42 CFR 402.105(d)(5), 42   CMS.................  Penalty for manufacturer         2018  ...........  ...........
                                         CFR 403.912(a) & (c).                            or group purchasing
                                                                                          organization failing to
                                                                                          report information
                                                                                          required under 42
                                                                                          U.S.C. 1320a-7h(a),
                                                                                          relating to physician
                                                                                          ownership or investment
                                                                                          interests:
                                                                                         Minimum.................         2018        1,128        1,156
                                                                                         Maximum.................         2018       11,278       11,562
                                                                                         Calendar Year Cap.......         2018      169,170      173,436
    1320a-7h(b)(2)....................  42 CFR 402.105(h), 42 CFR  CMS.................  Penalty for manufacturer         2018  ...........  ...........
                                         403.912(b) & (c).                                or group purchasing
                                                                                          organization knowingly
                                                                                          failing to report
                                                                                          information required
                                                                                          under 42 U.S.C. 1320a-
                                                                                          7h(a), relating to
                                                                                          physician ownership or
                                                                                          investment interests:
                                                                                         Minimum.................         2018       11,278       11,562
                                                                                         Maximum.................         2018      112,780      115,624
                                                                                         Calendar Year Cap.......         2018    1,127,799    1,156,242
                                                                   CMS.................  Penalty for an                   2018      112,780      115,624
                                                                                          administrator of a
                                                                                          facility that fails to
                                                                                          comply with notice
                                                                                          requirements for the
                                                                                          closure of a facility.
    1320a-7j(h)(3)(A).................  42 CFR 488.446(a)(1),      CMS.................  Minimum penalty for the          2018    564.28673          578
                                         (2), & (3).                                      first offense of an
                                                                                          administrator who fails
                                                                                          to provide notice of
                                                                                          facility closure.
                                                                                         Minimum penalty for the          2018        1,692        1,735
                                                                                          second offense of an
                                                                                          administrator who fails
                                                                                          to provide notice of
                                                                                          facility closure.
                                                                                         Minimum penalty for the          2018        3,383        3,468
                                                                                          third and subsequent
                                                                                          offenses of an
                                                                                          administrator who fails
                                                                                          to provide notice of
                                                                                          facility closure.
    1320a-8(a)(1).....................  .........................  CMS.................  Penalty for an entity            2018        8,249        8,457
                                                                                          knowingly making a
                                                                                          false statement or
                                                                                          representation of
                                                                                          material fact in the
                                                                                          determination of the
                                                                                          amount of benefits or
                                                                                          payments related to old-
                                                                                          age, survivors, and
                                                                                          disability insurance
                                                                                          benefits, special
                                                                                          benefits for certain
                                                                                          World War II veterans,
                                                                                          or supplemental
                                                                                          security income for the
                                                                                          aged, blind, and
                                                                                          disabled.
                                                                                         Penalty for violation of         2018        7,779        7,975
                                                                                          42 U.S.C. 1320a-8(a)(1)
                                                                                          if the violator is a
                                                                                          person who receives a
                                                                                          fee or other income for
                                                                                          services performed in
                                                                                          connection with
                                                                                          determination of the
                                                                                          benefit amount or the
                                                                                          person is a physician
                                                                                          or other health care
                                                                                          provider who submits
                                                                                          evidence in connection
                                                                                          with such a
                                                                                          determination.
    1320a-8(a)(3).....................  .........................  CMS.................  Penalty for a                    2018        6,460        6,623
                                                                                          representative payee
                                                                                          (under 42 U.S.C.
                                                                                          405(j), 1007, or
                                                                                          1383(a)(2)) converting
                                                                                          any part of a received
                                                                                          payment from the
                                                                                          benefit programs
                                                                                          described in the
                                                                                          previous civil monetary
                                                                                          penalty to a use other
                                                                                          than for the benefit of
                                                                                          the beneficiary.
    1320b-25(c)(1)(A).................  .........................  CMS.................  Penalty for failure of           2018      225,560      231,249
                                                                                          covered individuals to
                                                                                          report to the Secretary
                                                                                          and 1 or more law
                                                                                          enforcement officials
                                                                                          any reasonable
                                                                                          suspicion of a crime
                                                                                          against a resident, or
                                                                                          individual receiving
                                                                                          care, from a long-term
                                                                                          care facility.
    1320b-25(c)(2)(A).................  .........................  CMS.................  Penalty for failure of           2018      338,339      346,872
                                                                                          covered individuals to
                                                                                          report to the Secretary
                                                                                          and 1 or more law
                                                                                          enforcement officials
                                                                                          any reasonable
                                                                                          suspicion of a crime
                                                                                          against a resident, or
                                                                                          individual receiving
                                                                                          care, from a long-term
                                                                                          care facility if such
                                                                                          failure exacerbates the
                                                                                          harm to the victim of
                                                                                          the crime or results in
                                                                                          the harm to another
                                                                                          individual.
    1320b-25(d)(2)....................  .........................  CMS.................  Penalty for a long-term          2018      225,560      231,249
                                                                                          care facility that
                                                                                          retaliates against any
                                                                                          employee because of
                                                                                          lawful acts done by the
                                                                                          employee, or files a
                                                                                          complaint or report
                                                                                          with the State
                                                                                          professional
                                                                                          disciplinary agency
                                                                                          against an employee or
                                                                                          nurse for lawful acts
                                                                                          done by the employee or
                                                                                          nurse.

[[Page 59559]]

 
    1395b-7(b)(2)(B)..................  42 CFR 402.105(g)........  CMS.................  Penalty for any person           2018          152          156
                                                                                          who knowingly and
                                                                                          willfully fails to
                                                                                          furnish a beneficiary
                                                                                          with an itemized
                                                                                          statement of items or
                                                                                          services within 30 days
                                                                                          of the beneficiary's
                                                                                          request.
    1395i-3(h)(2)(B)(ii)(I)...........  42 CFR 488.408(d)(1)(iii)  CMS.................  Penalty per day for a            2018  ...........  ...........
                                                                                          Skilled Nursing
                                                                                          Facility that has a
                                                                                          Category 2 violation of
                                                                                          certification
                                                                                          requirements:
                                                                                         Minimum.................         2018          107          110
                                                                                         Maximum.................         2018        6,417        6,579
                                        42 CFR 488.408(d)(1)(iv).  CMS.................  Penalty per instance of          2018  ...........  ...........
                                                                                          Category 2
                                                                                          noncompliance by a
                                                                                          Skilled Nursing
                                                                                          Facility:
                                                                                         Minimum.................         2018        2,140        2,194
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.408(e)(1)(iii)  CMS.................  Penalty per day for a            2018  ...........  ...........
                                                                                          Skilled Nursing
                                                                                          Facility that has a
                                                                                          Category 3 violation of
                                                                                          certification
                                                                                          requirements:
                                                                                         Minimum.................         2018        6,525        6,690
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.408(e)(1)(iv).  CMS.................  Penalty per instance of          2018  ...........  ...........
                                                                                          Category 3
                                                                                          noncompliance by a
                                                                                          Skilled Nursing
                                                                                          Facility:
                                                                                         Minimum.................         2018        2,140        2,194
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.408(e)(2)(ii).  CMS.................  Penalty per day and per          2018  ...........  ...........
                                                                                          instance for a Skilled
                                                                                          Nursing Facility that
                                                                                          has Category 3
                                                                                          noncompliance with
                                                                                          Immediate Jeopardy:
                                                                                         Per Day (Minimum).......         2018        6,525        6,690
                                                                                         Per Day (Maximum).......         2018       21,393       21,933
                                                                                         Per Instance (Minimum)..         2018        2,140        2,194
                                                                                         Per Instance (Maximum)..         2018       21,393       21,933
                                        42 CFR 488.438(a)(1)(i)..  CMS.................  Penalty per day of a             2018  ...........  ...........
                                                                                          Skilled Nursing
                                                                                          Facility that fails to
                                                                                          meet certification
                                                                                          requirements. These
                                                                                          amounts represent the
                                                                                          upper range per day:
                                                                                         Minimum.................         2018        6,525        6,690
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.438(a)(1)(ii).  CMS.................  Penalty per day of a             2018  ...........  ...........
                                                                                          Skilled Nursing
                                                                                          Facility that fails to
                                                                                          meet certification
                                                                                          requirements. These
                                                                                          amounts represent the
                                                                                          lower range per day:
                                                                                         Minimum.................         2018          107          110
                                                                                         Maximum.................         2018        6,417        6,579
                                        42 CFR 488.438(a)(2).....  CMS.................  Penalty per instance of          2018  ...........  ...........
                                                                                          a Skilled Nursing
                                                                                          Facility that fails to
                                                                                          meet certification
                                                                                          requirements:
                                                                                         Minimum.................         2018        2,140        2,194
                                                                                         Maximum.................         2018       21,393       21,933
    1395l(h)(5)(D)....................  42 CFR 402.105(d)(2)(i)..  CMS.................  Penalty for knowingly,           2018       15,582       15,975
                                                                                          willfully, and
                                                                                          repeatedly billing for
                                                                                          a clinical diagnostic
                                                                                          laboratory test other
                                                                                          than on an assignment-
                                                                                          related basis.
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395l(i)(6).......................  .........................  CMS.................  Penalty for knowingly            2018        4,104        4,208
                                                                                          and willfully
                                                                                          presenting or causing
                                                                                          to be presented a bill
                                                                                          or request for payment
                                                                                          for an intraocular lens
                                                                                          inserted during or
                                                                                          after cataract surgery
                                                                                          for which the Medicare
                                                                                          payment rate includes
                                                                                          the cost of acquiring
                                                                                          the class of lens
                                                                                          involved.
    1395l(q)(2)(B)(i).................  42 CFR 402.105(a)........  CMS.................  Penalty for knowingly            2018        3,928        4,027
                                                                                          and willfully failing
                                                                                          to provide information
                                                                                          about a referring
                                                                                          physician when seeking
                                                                                          payment on an
                                                                                          unassigned basis.
    1395m(a)(11)(A)...................  42 CFR 402.1(c)(4),        CMS.................  Penalty for any durable          2018       15,582       15,975
                                         402.105(d)(2)(ii).                               medical equipment
                                                                                          supplier that knowingly
                                                                                          and willfully charges
                                                                                          for a covered service
                                                                                          that is furnished on a
                                                                                          rental basis after the
                                                                                          rental payments may no
                                                                                          longer be made.
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).

[[Page 59560]]

 
    1395m(a)(18)(B)...................  42 CFR 402.1(c)(5),        CMS.................  Penalty for any                  2018       15,582       15,975
                                         402.105(d)(2)(iii).                              nonparticipating
                                                                                          durable medical
                                                                                          equipment supplier that
                                                                                          knowingly and willfully
                                                                                          fails to make a refund
                                                                                          to Medicare
                                                                                          beneficiaries for a
                                                                                          covered service for
                                                                                          which payment is
                                                                                          precluded due to an
                                                                                          unsolicited telephone
                                                                                          contact from the
                                                                                          supplier. (Penalties
                                                                                          are assessed in the
                                                                                          same manner as 42
                                                                                          U.S.C. 1395u(j)(2)(B),
                                                                                          which is assessed
                                                                                          according to 1320a-
                                                                                          7a(a)).
    1395m(b)(5)(C)....................  42 CFR 402.1(c)(6),        CMS.................  Penalty for any                  2018       15,582       15,975
                                         402.105(d)(2)(iv).                               nonparticipating
                                                                                          physician or supplier
                                                                                          that knowingly and
                                                                                          willfully charges a
                                                                                          Medicare beneficiary
                                                                                          more than the limiting
                                                                                          charge for radiologist
                                                                                          services. (Penalties
                                                                                          are assessed in the
                                                                                          same manner as 42
                                                                                          U.S.C. 1395u(j)(2)(B),
                                                                                          which is assessed
                                                                                          according to 1320a-
                                                                                          7a(a)).
    1395m(h)(3).......................  42 CFR 402.1(c)(8),        CMS.................  Penalty for any supplier         2018       15,582       15,975
                                         402.105(d)(2)(vi).                               of prosthetic devices,
                                                                                          orthotics, and
                                                                                          prosthetics that
                                                                                          knowing and willfully
                                                                                          charges for a covered
                                                                                          prosthetic device,
                                                                                          orthotic, or prosthetic
                                                                                          that is furnished on a
                                                                                          rental basis after the
                                                                                          rental payment may no
                                                                                          longer be made.
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395m(a)(11)(A), that
                                                                                          is in the same manner
                                                                                          as 1395u(j)(2)(B),
                                                                                          which is assessed
                                                                                          according to 1320a-
                                                                                          7a(a)).
    1395m(j)(2)(A)(iii)...............  .........................  CMS.................  Penalty for any supplier         2018        1,650        1,692
                                                                                          of durable medical
                                                                                          equipment including a
                                                                                          supplier of prosthetic
                                                                                          devices, prosthetics,
                                                                                          orthotics, or supplies
                                                                                          that knowingly and
                                                                                          willfully distributes a
                                                                                          certificate of medical
                                                                                          necessity in violation
                                                                                          of Section
                                                                                          1834(j)(2)(A)(i) of the
                                                                                          Act or fails to provide
                                                                                          the information
                                                                                          required under Section
                                                                                          1834(j)(2)(A)(ii) of
                                                                                          the Act.
    1395m(j)(4).......................  42 CFR 402.1(c)(10),       CMS.................  Penalty for any supplier         2018       15,582       15,975
                                         402.105(d)(2)(vii).                              of durable medical
                                                                                          equipment, including a
                                                                                          supplier of prosthetic
                                                                                          devices, prosthetics,
                                                                                          orthotics, or supplies
                                                                                          that knowingly and
                                                                                          willfully fails to make
                                                                                          refunds in a timely
                                                                                          manner to Medicare
                                                                                          beneficiaries for
                                                                                          series billed other
                                                                                          than on as assignment-
                                                                                          related basis under
                                                                                          certain conditions.
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C. 1395m(j)(4)
                                                                                          and 1395u(j)(2)(B),
                                                                                          which is assessed
                                                                                          according to 1320a-
                                                                                          7a(a)).
    1395m(k)(6).......................  42 CFR 402.1(c)(31),       CMS.................  Penalty for any person           2018       15,582       15,975
                                         402.105(d)(3).                                   or entity who knowingly
                                                                                          and willfully bills or
                                                                                          collects for any
                                                                                          outpatient therapy
                                                                                          services or
                                                                                          comprehensive
                                                                                          outpatient
                                                                                          rehabilitation services
                                                                                          on other than an
                                                                                          assignment-related
                                                                                          basis. (Penalties are
                                                                                          assessed in the same
                                                                                          manner as 42 U.S.C.
                                                                                          1395m(k)(6) and
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395m(l)(6).......................  42 CFR 402.1(c)(32),       CMS.................  Penalty for any supplier         2018       15,582       15,975
                                         402.105(d)(4).                                   of ambulance services
                                                                                          who knowingly and
                                                                                          willfully fills or
                                                                                          collects for any
                                                                                          services on other than
                                                                                          an assignment-related
                                                                                          basis. (Penalties are
                                                                                          assessed in the same
                                                                                          manner as 42 U.S.C.
                                                                                          1395u(b)(18)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395u(b)(18)(B)...................  42 CFR 402.1(c)(11),       CMS.................  Penalty for any                  2018       15,582       15,975
                                         402.105(d)(2)(viii).                             practitioner specified
                                                                                          in Section
                                                                                          1842(b)(18)(C) of the
                                                                                          Act or other person
                                                                                          that knowingly and
                                                                                          willfully bills or
                                                                                          collects for any
                                                                                          services by the
                                                                                          practitioners on other
                                                                                          than an assignment-
                                                                                          related basis.
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).

[[Page 59561]]

 
    1395u(j)(2)(B)....................  42 CFR 402.1(c)..........  CMS.................  Penalty for any                  2018       15,582       15,975
                                                                                          physician who charges
                                                                                          more than 125% for a
                                                                                          non-participating
                                                                                          referral. (Penalties
                                                                                          are assessed in the
                                                                                          same manner as 42
                                                                                          U.S.C. 1320a-7a(a)).
    1395u(k)..........................  42 CFR 402.1(c)(12),       CMS.................  Penalty for any                  2018       15,582       15,975
                                         402.105(d)(2)(ix).                               physician who knowingly
                                                                                          and willfully presents
                                                                                          or causes to be
                                                                                          presented a claim for
                                                                                          bill for an assistant
                                                                                          at a cataract surgery
                                                                                          performed on or after
                                                                                          March 1, 1987, for
                                                                                          which payment may not
                                                                                          be made because of
                                                                                          section 1862(a)(15).
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395u(l)(3).......................  42 CFR 402.1(c)(13),       CMS.................  Penalty for any                  2018       15,582       15,975
                                         402.105(d)(2)(x).                                nonparticipating
                                                                                          physician who does not
                                                                                          accept payment on an
                                                                                          assignment-related
                                                                                          basis and who knowingly
                                                                                          and willfully fails to
                                                                                          refund on a timely
                                                                                          basis any amounts
                                                                                          collected for services
                                                                                          that are not reasonable
                                                                                          or medically necessary
                                                                                          or are of poor quality
                                                                                          under 1842(l)(1)(A).
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395u(m)(3).......................  42 CFR 402.1(c)(14),       CMS.................  Penalty for any                  2018       15,582       15,975
                                         402.105(d)(2)(xi).                               nonparticipating
                                                                                          physician charging more
                                                                                          than $500 who does not
                                                                                          accept payment for an
                                                                                          elective surgical
                                                                                          procedure on an
                                                                                          assignment related
                                                                                          basis and who knowingly
                                                                                          and willfully fails to
                                                                                          disclose the required
                                                                                          information regarding
                                                                                          charges and coinsurance
                                                                                          amounts and fails to
                                                                                          refund on a timely
                                                                                          basis any amount
                                                                                          collected for the
                                                                                          procedure in excess of
                                                                                          the charges recognized
                                                                                          and approved by the
                                                                                          Medicare program.
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395u(n)(3).......................  42 CFR 402.1(c)(15),       CMS.................  Penalty for any                  2018       15,582       15,975
                                         402.105(d)(2)(xii).                              physician who
                                                                                          knowingly, willfully,
                                                                                          and repeatedly bills
                                                                                          one or more
                                                                                          beneficiaries for
                                                                                          purchased diagnostic
                                                                                          tests any amount other
                                                                                          than the payment amount
                                                                                          specified by the Act.
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395u(o)(3)(B)....................  42 CFR 414.707(b)........  CMS.................  Penalty for any                  2018       15,582       15,975
                                                                                          practitioner specified
                                                                                          in Section
                                                                                          1842(b)(18)(C) of the
                                                                                          Act or other person
                                                                                          that knowingly and
                                                                                          willfully bills or
                                                                                          collects for any
                                                                                          services pertaining to
                                                                                          drugs or biologics by
                                                                                          the practitioners on
                                                                                          other than an
                                                                                          assignment-related
                                                                                          basis. (Penalties are
                                                                                          assessed in the same
                                                                                          manner as 42 U.S.C.
                                                                                          1395u(b)(18)(B) and
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395u(p)(3)(A)....................  .........................  CMS.................  Penalty for any                  2018        4,104        4,208
                                                                                          physician or
                                                                                          practitioner who
                                                                                          knowingly and willfully
                                                                                          fails promptly to
                                                                                          provide the appropriate
                                                                                          diagnosis codes upon
                                                                                          CMS or Medicare
                                                                                          administrative
                                                                                          contractor request for
                                                                                          payment or bill not
                                                                                          submitted on an
                                                                                          assignment-related
                                                                                          basis.
    1395w-3a(d)(4)(A).................  42 CFR 414.806...........  CMS.................  Penalty for a                    2018       13,333       13,669
                                                                                          pharmaceutical
                                                                                          manufacturer's
                                                                                          misrepresentation of
                                                                                          average sales price of
                                                                                          a drug, or biologic.

[[Page 59562]]

 
    1395w-4(g)(1)(B)..................  42 CFR 402.1(c)(17),       CMS.................  Penalty for any                  2018       15,582       15,975
                                         402.105(d)(2)(xiii).                             nonparticipating
                                                                                          physician, supplier, or
                                                                                          other person that
                                                                                          furnishes physician
                                                                                          services not on an
                                                                                          assignment-related
                                                                                          basis who either
                                                                                          knowingly and willfully
                                                                                          bills or collects in
                                                                                          excess of the
                                                                                          statutorily-defined
                                                                                          limiting charge or
                                                                                          fails to make a timely
                                                                                          refund or adjustment.
                                                                                          (Penalties are assessed
                                                                                          in the same manner as
                                                                                          42 U.S.C.
                                                                                          1395u(j)(2)(B), which
                                                                                          is assessed according
                                                                                          to 1320a-7a(a)).
    1395w-4(g)(3)(B)..................  42 CFR 402.1(c)(18),       CMS.................  Penalty for any person           2018       15,582       15,975
                                         402.105(d)(2)(xiv).                              that knowingly and
                                                                                          willfully bills for
                                                                                          statutorily defined
                                                                                          State-plan approved
                                                                                          physicians' services on
                                                                                          any other basis than an
                                                                                          assignment-related
                                                                                          basis for a Medicare/
                                                                                          Medicaid dual eligible
                                                                                          beneficiary. (Penalties
                                                                                          are assessed in the
                                                                                          same manner as 42
                                                                                          U.S.C. 1395u(j)(2)(B),
                                                                                          which is assessed
                                                                                          according to 1320a-
                                                                                          7a(a)).
    1395w-27(g)(3)(A); 1857(g)(3) (A).  42 CFR 422.760(b)(1)-(2);  CMS.................  Penalty for each                 2018       38,159       39,121
                                         42 CFR 423.760(b)(1)-(2).                        termination
                                                                                          determination the
                                                                                          Secretary makes that is
                                                                                          the result of actions
                                                                                          by a Medicare Advantage
                                                                                          organization or Part D
                                                                                          sponsor that has
                                                                                          adversely affected an
                                                                                          individual covered
                                                                                          under the
                                                                                          organization's contract.
    1395w-27(g)(3)(B); 1857(g)(3)(B)..  42 CFR 422.760(b)(3); 42   CMS.................  Penalty for each week            2018       15,264       15,649
                                         CFR 423.760(b)(3).                               beginning after the
                                                                                          initiation of civil
                                                                                          money penalty
                                                                                          procedures by the
                                                                                          Secretary because a
                                                                                          Medicare Advantage
                                                                                          organization or Part D
                                                                                          sponsor has failed to
                                                                                          carry out a contract,
                                                                                          or has carried out a
                                                                                          contract inconsistently
                                                                                          with regulations.
    1395w-27(g)(3)(D); 1857(g)(3)(D)..  .........................  CMS.................  Penalty for a Medicare           2018      141,760      145,335
                                                                                          Advantage
                                                                                          organization's or Part
                                                                                          D sponsor's early
                                                                                          termination of its
                                                                                          contract.
    1395y(b)(3)(C)....................  42 CFR 411.103(b)........  CMS.................  Penalty for an employer          2018        9,239        9,472
                                                                                          or other entity to
                                                                                          offer any financial or
                                                                                          other incentive for an
                                                                                          individual entitled to
                                                                                          benefits not to enroll
                                                                                          under a group health
                                                                                          plan or large group
                                                                                          health plan which would
                                                                                          be a primary plan.
    1395y(b)(5)(C)(ii)................  42 CFR 402.1(c)(20), 42    CMS.................  Penalty for any non-             2018        1,504        1,542
                                         CFR 402.105(b)(2).                               governmental employer
                                                                                          that, before October 1,
                                                                                          1998, willfully or
                                                                                          repeatedly failed to
                                                                                          provide timely and
                                                                                          accurate information
                                                                                          requested relating to
                                                                                          an employee's group
                                                                                          health insurance
                                                                                          coverage.
    1395y(b)(6)(B)....................  42 CFR 402.1(c)(21),       CMS.................  Penalty for any entity           2018        3,300        3,383
                                         402.105(a).                                      that knowingly,
                                                                                          willfully, and
                                                                                          repeatedly fails to
                                                                                          complete a claim form
                                                                                          relating to the
                                                                                          availability of other
                                                                                          health benefits in
                                                                                          accordance with statute
                                                                                          or provides inaccurate
                                                                                          information relating to
                                                                                          such on the claim form.
    1395y(b)(7)(B)(i).................  .........................  CMS.................  Penalty for any entity           2018        1,181        1,211
                                                                                          serving as insurer,
                                                                                          third party
                                                                                          administrator, or
                                                                                          fiduciary for a group
                                                                                          health plan that fails
                                                                                          to provide information
                                                                                          that identifies
                                                                                          situations where the
                                                                                          group health plan is or
                                                                                          was a primary plan to
                                                                                          Medicare to the HHS
                                                                                          Secretary.
    1395y(b)(8)(E)....................  .........................  CMS.................  Penalty for any non-             2018        1,181        1,211
                                                                                          group health plan that
                                                                                          fails to identify
                                                                                          claimants who are
                                                                                          Medicare beneficiaries
                                                                                          and provide information
                                                                                          to the HHS Secretary to
                                                                                          coordinate benefits and
                                                                                          pursue any applicable
                                                                                          recovery claim.
    1395nn(g)(5)......................  42 CFR 411.361...........  CMS.................  Penalty for any person           2018       19,639       20,134
                                                                                          that fails to report
                                                                                          information required by
                                                                                          HHS under Section
                                                                                          1877(f) concerning
                                                                                          ownership, investment,
                                                                                          and compensation
                                                                                          arrangements.

[[Page 59563]]

 
    1395pp(h).........................  42 CFR 402.1(c)(23),       CMS.................  Penalty for any durable          2018       15,582       15,975
                                         402.105(d)(2)(xv).                               medical equipment
                                                                                          supplier, including a
                                                                                          supplier of prosthetic
                                                                                          devices, prosthetics,
                                                                                          orthotics, or supplies,
                                                                                          that knowingly and
                                                                                          willfully fails to make
                                                                                          refunds in a timely
                                                                                          manner to Medicare
                                                                                          beneficiaries under
                                                                                          certain conditions. (42
                                                                                          U.S.C. 1395(m)(18)
                                                                                          sanctions apply here in
                                                                                          the same manner, which
                                                                                          is under 1395u(j)(2)
                                                                                          and 1320a-7a(a)).
    1395ss(a)(2)......................  42 CFR 402.1(c)(24),       CMS.................  Penalty for any person           2018       53,483       54,832
                                         405.105(f)(1).                                   that issues a Medicare
                                                                                          supplemental policy
                                                                                          that has not been
                                                                                          approved by the State
                                                                                          regulatory program or
                                                                                          does not meet Federal
                                                                                          standards after a
                                                                                          statutorily defined
                                                                                          effective date.
    1395ss(d)(3)(A)(vi) (II)..........  .........................  CMS.................  Penalty for someone              2018       27,714       28,413
                                                                                          other than issuer that
                                                                                          sells or issues a
                                                                                          Medicare supplemental
                                                                                          policy to beneficiary
                                                                                          without a disclosure
                                                                                          statement.
                                                                                         Penalty for an issuer            2018       46,192       47,357
                                                                                          that sells or issues a
                                                                                          Medicare supplemental
                                                                                          policy without
                                                                                          disclosure statement.
    1395ss(d)(3)(B)(iv)...............  .........................  CMS.................  Penalty for someone              2018       27,714       28,413
                                                                                          other than issuer that
                                                                                          sells or issues a
                                                                                          Medicare supplemental
                                                                                          policy without
                                                                                          acknowledgement form.
                                                                                         Penalty for issuer that          2018       46,192       47,357
                                                                                          sells or issues a
                                                                                          Medicare supplemental
                                                                                          policy without an
                                                                                          acknowledgement form.
    1395ss(p)(8)......................  42 CFR 402.1(c)(25),       CMS.................  Penalty for any person           2018       27,714       28,413
                                         402.105(e).                                      that sells or issues
                                                                                          Medicare supplemental
                                                                                          polices after a given
                                                                                          date that fail to
                                                                                          conform to the NAIC or
                                                                                          Federal standards
                                                                                          established by statute.
                                        42 CFR 402.1(c)(25),       CMS.................  Penalty for any person           2018       46,192       47,357
                                         405.105(f)(2).                                   that sells or issues
                                                                                          Medicare supplemental
                                                                                          polices after a given
                                                                                          date that fail to
                                                                                          conform to the NAIC or
                                                                                          Federal standards
                                                                                          established by statute.
    1395ss(p)(9)(C)...................  42 CFR 402.1(c)(26),       CMS.................  Penalty for any person           2018       27,714       28,413
                                         402.105(e).                                      that sells a Medicare
                                                                                          supplemental policy and
                                                                                          fails to make available
                                                                                          for sale the core group
                                                                                          of basic benefits when
                                                                                          selling other Medicare
                                                                                          supplemental policies
                                                                                          with additional
                                                                                          benefits or fails to
                                                                                          provide the individual,
                                                                                          before selling the
                                                                                          policy, an outline of
                                                                                          coverage describing
                                                                                          benefits.
                                        42 CFR 402.1(c)(26),       ....................  Penalty for any person           2018       46,192       47,357
                                         405.105(f)(3), (4).                              that sells a Medicare
                                                                                          supplemental policy and
                                                                                          fails to make available
                                                                                          for sale the core group
                                                                                          of basic benefits when
                                                                                          selling other Medicare
                                                                                          supplemental policies
                                                                                          with additional
                                                                                          benefits or fails to
                                                                                          provide the individual,
                                                                                          before selling the
                                                                                          policy, an outline of
                                                                                          coverage describing
                                                                                          benefits.
    1395ss(q)(5)(C)...................  42 CFR 402.1(c)(27),       CMS.................  Penalty for any person           2018       46,192       47,357
                                         405.105(f)(5).                                   that fails to suspend
                                                                                          the policy of a
                                                                                          policyholder made
                                                                                          eligible for medical
                                                                                          assistance or
                                                                                          automatically
                                                                                          reinstates the policy
                                                                                          of a policyholder who
                                                                                          has lost eligibility
                                                                                          for medical assistance,
                                                                                          under certain
                                                                                          circumstances.
    1395ss(r)(6)(A)...................  42 CFR 402.1(c)(28),       CMS.................  Penalty for any person           2018       46,192       47,357
                                         405.105(f)(6).                                   that fails to provide
                                                                                          refunds or credits as
                                                                                          required by section
                                                                                          1882(r)(1)(B).
    1395ss(s)(4)......................  42 CFR 402.1(c)(29),       CMS.................  Penalty for any issuer           2018       19,609       20,104
                                         405.105(c).                                      of a Medicare
                                                                                          supplemental policy
                                                                                          that does not waive
                                                                                          listed time periods if
                                                                                          they were already
                                                                                          satisfied under a
                                                                                          proceeding Medicare
                                                                                          supplemental policy, or
                                                                                          denies a policy, or
                                                                                          conditions the
                                                                                          issuances or
                                                                                          effectiveness of the
                                                                                          policy, or
                                                                                          discriminates in the
                                                                                          pricing of the policy
                                                                                          base on health status
                                                                                          or other specified
                                                                                          criteria.
    1395ss(t)(2)......................  42 CFR 402.1(c)(30),       CMS.................  Penalty for any issuer           2018       46,192       47,357
                                         405.105(f)(7).                                   of a Medicare
                                                                                          supplemental policy
                                                                                          that fails to fulfill
                                                                                          listed responsibilities.

[[Page 59564]]

 
    1395ss(v)(4)(A)...................  .........................  CMS.................  Penalty someone other            2018       19,999       20,503
                                                                                          than issuer who sells,
                                                                                          issues, or renews a
                                                                                          medigap Rx policy to an
                                                                                          individual who is a
                                                                                          Part D enrollee.
                                                                                         Penalty for an issuer            2018       33,333       34,174
                                                                                          who sells, issues, or
                                                                                          renews a Medigap Rx
                                                                                          policy who is a Part D
                                                                                          enrollee.
    1395bbb(c)(1).....................  42 CFR 488.725(c)........  CMS.................  Penalty for any                  2018        4,280        4,388
                                                                                          individual who notifies
                                                                                          or causes to be
                                                                                          notified a home health
                                                                                          agency of the time or
                                                                                          date on which a survey
                                                                                          of such agency is to be
                                                                                          conducted.
    1395bbb(f)(2)(A)(i)...............  42 CFR 488.845(b)(2)(iii)  CMS.................  Maximum daily penalty            2018       20,521       21,039
                                         42 CFR 488.845(b)(3)-                            amount for each day a
                                         (6); and 42 CFR                                  home health agency is
                                         488.845(d)(1)(ii).                               not in compliance with
                                                                                          statutory requirements.
                                        42 CFR 488.845(b)(3).....  ....................  Penalty per day for home         2018  ...........  ...........
                                                                                          health agency's
                                                                                          noncompliance (Upper
                                                                                          Range):
                                                                                         Minimum.................         2018       17,443       17,883
                                                                                         Maximum.................         2018       20,521       21,039
                                        42 CFR 488.845(b)(3)(i)..  ....................  Penalty for a home               2018       20,521       21,039
                                                                                          health agency's
                                                                                          deficiency or
                                                                                          deficiencies that cause
                                                                                          immediate jeopardy and
                                                                                          result in actual harm.
                                        42 CFR 488.845(b)(3)(ii).  ....................  Penalty for a home               2018       18,468       18,934
                                                                                          health agency's
                                                                                          deficiency or
                                                                                          deficiencies that cause
                                                                                          immediate jeopardy and
                                                                                          result in potential for
                                                                                          harm.
                                        42 CFR 488.845(b)(3)(iii)  ....................  Penalty for an isolated          2018       17,443       17,883
                                                                                          incident of
                                                                                          noncompliance in
                                                                                          violation of
                                                                                          established HHA policy.
                                        42 CFR 488.845(b)(4).....  ....................  Penalty for a repeat and/        2018  ...........  ...........
                                                                                          or condition-level
                                                                                          deficiency that does
                                                                                          not constitute
                                                                                          immediate jeopardy, but
                                                                                          is directly related to
                                                                                          poor quality patient
                                                                                          care outcomes (Lower
                                                                                          Range):
                                                                                         Minimum.................         2018        3,079        3,157
                                                                                         Maximum.................         2018       17,443       17,883
                                        42 CFR 488.845(b)(5).....  ....................  Penalty for a repeat and/        2018  ...........  ...........
                                                                                          or condition-level
                                                                                          deficiency that does
                                                                                          not constitute
                                                                                          immediate jeopardy and
                                                                                          that is related
                                                                                          predominately to
                                                                                          structure or process-
                                                                                          oriented conditions
                                                                                          (Lower Range):
                                                                                         Minimum.................         2018        1,026        1,052
                                                                                         Maximum.................         2018        8,208        8,415
                                        42 CFR 488.845(b)(6).....  ....................  Penalty imposed for              2018  ...........  ...........
                                                                                          instance of
                                                                                          noncompliance that may
                                                                                          be assessed for one or
                                                                                          more singular events of
                                                                                          condition-level
                                                                                          noncompliance that are
                                                                                          identified and where
                                                                                          the noncompliance was
                                                                                          corrected during the
                                                                                          onsite survey:
                                                                                         Minimum.................         2018        2,052        2,104
                                                                                         Maximum.................         2018       20,521       21,039
                                                                                         Penalty for each day of          2018       20,521       21,039
                                                                                          noncompliance (Maximum).
                                        42 CFR 488.845(d)(1)(ii).  ....................  Penalty for each day of          2018       20,521       21,039
                                                                                          noncompliance (Maximum).
    1396b(m)(5)(B)....................  42 CFR 460.46 (a)(1).....  CMS.................  Penalty for                      2018  ...........  ...........
                                                                                          discriminating or
                                                                                          discouraging enrollment
                                                                                          or disenrollment of
                                                                                          participants on the
                                                                                          basis of an
                                                                                          individual's health
                                                                                          status or need for
                                                                                          health care services.
                                        42 CFR 460.46 (a)(1).....  ....................  Minimum.................         2018       22,896       23,473
                                        42 CFR 460.46 (a)(1).....  ....................  Maximum.................         2018      152,638      156,488
                                        42 CFR 460.46 (a)(2).....  ....................  Penalty for a PACE               2018       38,159       39,121
                                                                                          organization that
                                                                                          charges excessive
                                                                                          premiums.
                                        42 CFR 460.46 (a)(3).....  ....................  Penalty for a PACE               2018      152,638      156,488
                                                                                          organization
                                                                                          misrepresenting or
                                                                                          falsifying information
                                                                                          to CMS, the State, or
                                                                                          an individual or other
                                                                                          entity.
                                        42 CFR 460.46 (a)(4).....  ....................  Penalty for each                 2018       38,159       39,121
                                                                                          determination the CMS
                                                                                          makes that the PACE
                                                                                          organization has failed
                                                                                          to provide medically
                                                                                          necessary items and
                                                                                          services of the failure
                                                                                          has adversely affected
                                                                                          (or has the substantial
                                                                                          likelihood of adversely
                                                                                          affecting) a PACE
                                                                                          participant.
                                        42 CFR 460.46 (a)(4).....  ....................  Penalty for                      2018       38,159       39,121
                                                                                          involuntarily
                                                                                          disenrolling a
                                                                                          participant.

[[Page 59565]]

 
                                        42 CFR 460.46 (a)(4).....  ....................  Penalty for PACE                 2018       38,159       39,121
                                                                                          organization's practice
                                                                                          that would reasonably
                                                                                          be expected to have the
                                                                                          effect of denying or
                                                                                          discouraging enrollment.
    1396r(h)(3)(C)(ii)(I).............  42 CFR 488.408(d)(1)(iii)  CMS.................  Penalty per day for a            2018  ...........  ...........
                                                                                          nursing facility's
                                                                                          failure to meet a
                                                                                          Category 2
                                                                                          Certification:
                                                                                         Minimum.................         2018    107.14305          110
                                                                                         Maximum.................         2018        6,417        6,579
                                        42 CFR 488.408(d)(1)(iv).  CMS.................  Penalty per instance for         2018  ...........  ...........
                                                                                          a nursing facility's
                                                                                          failure to meet
                                                                                          Category 2
                                                                                          certification:
                                                                                         Minimum.................         2018        2,140        2,194
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.408(e)(1)(iii)  CMS.................  Penalty per day for a            2018  ...........  ...........
                                                                                          nursing facility's
                                                                                          failure to meet
                                                                                          Category 3
                                                                                          certification:
                                                                                         Minimum.................         2018        6,525        6,690
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.408(e)(1)(iv).  CMS.................  Penalty per instance for         2018  ...........  ...........
                                                                                          a nursing facility's
                                                                                          failure to meet
                                                                                          Category 3
                                                                                          certification:
                                                                                         Minimum.................         2018        2,140        2,194
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.408(e)(2)(ii).  CMS.................  Penalty per instance for         2018  ...........  ...........
                                                                                          a nursing facility's
                                                                                          failure to meet
                                                                                          Category 3
                                                                                          certification, which
                                                                                          results in immediate
                                                                                          jeopardy:
                                                                                         Minimum.................         2018        2,140        2,194
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.438(a)(1)(i)..  CMS.................  Penalty per day for              2018  ...........  ...........
                                                                                          nursing facility's
                                                                                          failure to meet
                                                                                          certification (Upper
                                                                                          Range):
                                                                                         Minimum.................         2018        6,525        6,690
                                                                                         Maximum.................         2018       21,393       21,933
                                        42 CFR 488.438(a)(1)(ii).  CMS.................  Penalty per day for              2018  ...........  ...........
                                                                                          nursing facility's
                                                                                          failure to meet
                                                                                          certification (Lower
                                                                                          Range):
                                                                                         Minimum.................         2018    107.14305          110
                                                                                         Maximum.................         2018        6,417        6,579
                                        42 CFR 488.438(a)(2).....  CMS.................  Penalty per instance for         2018  ...........  ...........
                                                                                          nursing facility's
                                                                                          failure to meet
                                                                                          certification:
                                                                                         Minimum.................         2018        2,140        2,194
                                                                                         Maximum.................         2018       21,393       21,933
    1396r(f)(2)(B)(iii)(I)(c).........  42 CFR 483.151(b)(2)(iv)   CMS.................  Grounds to prohibit              2018       10,697       10,967
                                         and (b)(3)(iii).                                 approval of Nurse Aide
                                                                                          Training Program--if
                                                                                          assessed a penalty in
                                                                                          1819(h)(2)(B)(i) or
                                                                                          1919(h)(2)(A)(ii) of
                                                                                          ``not less than
                                                                                          $5,000'' [Not CMP
                                                                                          authority, but a
                                                                                          specific CMP amount
                                                                                          (CMP at this level)
                                                                                          that is the triggering
                                                                                          condition for
                                                                                          disapproval].
    1396r(h)(3)(C)(ii)(I).............  42 CFR 483.151(c)(2).....  CMS.................  Grounds to waive                 2018       10,697       10,967
                                                                                          disapproval of nurse
                                                                                          aide training program--
                                                                                          reference to
                                                                                          disapproval based on
                                                                                          imposition of CMP ``not
                                                                                          less than $5,000'' [Not
                                                                                          CMP authority but CMP
                                                                                          imposition at this
                                                                                          level determines
                                                                                          eligibility to seek
                                                                                          waiver of disapproval
                                                                                          of nurse aide training
                                                                                          program].
    1396t(j)(2)(C)....................  .........................  CMS.................  Penalty for each day of          2018  ...........  ...........
                                                                                          noncompliance for a
                                                                                          home or community care
                                                                                          provider that no longer
                                                                                          meets the minimum
                                                                                          requirements for home
                                                                                          and community care:
                                                                                         Minimum.................         2018            2            2
                                                                                         Maximum.................         2018       18,477       18,943
    1396u-2(e)(2)(A)(i)...............  42 CFR 438.704...........  CMS.................  Penalty for a Medicaid           2018       38,159       39,121
                                                                                          managed care
                                                                                          organization that fails
                                                                                          substantially to
                                                                                          provide medically
                                                                                          necessary items and
                                                                                          services.
                                                                                         Penalty for Medicaid             2018       38,159       39,121
                                                                                          managed care
                                                                                          organization that
                                                                                          imposes premiums or
                                                                                          charges on enrollees in
                                                                                          excess of the premiums
                                                                                          or charges permitted.
                                                                                         Penalty for a Medicaid           2018       38,159       39,121
                                                                                          managed care
                                                                                          organization that
                                                                                          misrepresents or
                                                                                          falsifies information
                                                                                          to another individual
                                                                                          or entity.
                                                                                         Penalty for a Medicaid           2018       38,159       39,121
                                                                                          managed care
                                                                                          organization that fails
                                                                                          to comply with the
                                                                                          applicable statutory
                                                                                          requirements for such
                                                                                          organizations.
    1396u-2(e)(2)(A)(ii)..............  42 CFR 438.704...........  CMS.................  Penalty for a Medicaid           2018      152,638      156,488
                                                                                          managed care
                                                                                          organization that
                                                                                          misrepresents or
                                                                                          falsifies information
                                                                                          to the HHS Secretary.

[[Page 59566]]

 
                                                                                         Penalty for Medicaid             2018      152,638      156,488
                                                                                          managed care
                                                                                          organization that acts
                                                                                          to discriminate among
                                                                                          enrollees on the basis
                                                                                          of their health status.
    1396u-2(e)(2)(A)(iv)..............  42 CFR 438.704...........  CMS.................  Penalty for each                 2018       22,896       23,473
                                                                                          individual that does
                                                                                          not enroll as a result
                                                                                          of a Medicaid managed
                                                                                          care organization that
                                                                                          acts to discriminate
                                                                                          among enrollees on the
                                                                                          basis of their health
                                                                                          status.
    1396u(h)(2).......................  42 CFR Part 441, Subpart   CMS.................  Penalty for a provider           2018       21,393       21,933
                                         I.                                               not meeting one of the
                                                                                          requirements relating
                                                                                          to the protection of
                                                                                          the health, safety, and
                                                                                          welfare of individuals
                                                                                          receiving community
                                                                                          supported living
                                                                                          arrangements services.
    1396w-2(c)(1).....................  .........................  CMS.................  Penalty for disclosing           2018       11,410       11,698
                                                                                          information related to
                                                                                          eligibility
                                                                                          determinations for
                                                                                          medical assistance
                                                                                          programs.
    18041(c)(2).......................  45 CFR 150.315; 45 CFR     CMS.................  Failure to comply with           2018    155.10232          159
                                         156.805(c).                                      requirements of the
                                                                                          Public Health Services
                                                                                          Act; Penalty for
                                                                                          violations of rules or
                                                                                          standards of behavior
                                                                                          associated with issuer
                                                                                          participation in the
                                                                                          Federally-facilitated
                                                                                          Exchange. (42 U.S.C.
                                                                                          300gg-22(b)(2)(C)).
    18081(h)(1)(A)(i)(II).............  42 CFR 155.285...........  CMS.................  Penalty for providing            2018       28,195       28,906
                                                                                          false information on
                                                                                          Exchange application.
    18081(h)(1)(B)....................  42 CFR 155.285...........  CMS.................  Penalty for knowingly or         2018      281,949      289,060
                                                                                          willfully providing
                                                                                          false information on
                                                                                          Exchange application.
    18081(h)(2).......................  42 CFR 155.260...........  CMS.................  Penalty for knowingly or         2018       28,195       28,906
                                                                                          willfully disclosing
                                                                                          protected information
                                                                                          from Exchange.
31 U.S.C.:
    1352..............................  45 CFR 93.400(e).........  HHS.................  Penalty for the first            2018       19,639       20,134
                                                                                          time an individual
                                                                                          makes an expenditure
                                                                                          prohibited by
                                                                                          regulations regarding
                                                                                          lobbying disclosure,
                                                                                          absent aggravating
                                                                                          circumstances.
                                                                                         Penalty for second and           2018  ...........  ...........
                                                                                          subsequent offenses by
                                                                                          individuals who make an
                                                                                          expenditure prohibited
                                                                                          by regulations
                                                                                          regarding lobbying
                                                                                          disclosure:
                                                                                         Minimum.................         2018       19,639       20,134
                                                                                         Maximum.................         2018      196,387      201,340
                                                                                         Penalty for the first            2018       19,639       20,134
                                                                                          time an individual
                                                                                          fails to file or amend
                                                                                          a lobbying disclosure
                                                                                          form, absent
                                                                                          aggravating
                                                                                          circumstances.
                                                                                         Penalty for second and           2018  ...........  ...........
                                                                                          subsequent offenses by
                                                                                          individuals who fail to
                                                                                          file or amend a
                                                                                          lobbying disclosure
                                                                                          form, absent
                                                                                          aggravating
                                                                                          circumstances:
                                                                                         Minimum.................         2018       19,639       20,134
                                                                                         Maximum.................         2018      196,387      201,340
                                        45 CFR Part 93, Appendix   HHS.................  Penalty for failure to           2018  ...........  ...........
                                         A.                                               provide certification
                                                                                          regarding lobbying in
                                                                                          the award documents for
                                                                                          all sub-awards of all
                                                                                          tiers:
                                                                                         Minimum.................         2018       19,639       20,134
                                                                                         Maximum.................         2018      196,387      201,340
                                                                                         Penalty for failure to           2018  ...........  ...........
                                                                                          provide statement
                                                                                          regarding lobbying for
                                                                                          loan guarantee and loan
                                                                                          insurance transactions:
                                                                                         Minimum.................         2018       19,639       20,134
                                                                                         Maximum.................         2018      196,387      201,340
    3801-3812.........................  45 CFR 79.3(a)(1)(iv)....  HHS.................  Penalty against any              2018       10,261       10,520
                                                                                          individual who--with
                                                                                          knowledge or reason to
                                                                                          know--makes, presents
                                                                                          or submits a false,
                                                                                          fictitious or
                                                                                          fraudulent claim to the
                                                                                          Department.
                                        45 CFR 79.3(b)(1)(ii)....  ....................  Penalty against any              2018       10,261       10,520
                                                                                          individual who--with
                                                                                          knowledge or reason to
                                                                                          know--makes, presents
                                                                                          or submits a false,
                                                                                          fictitious or
                                                                                          fraudulent claim to the
                                                                                          Department.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Some HHS components have not promulgated regulations regarding their civil monetary penalty-specific statutory authorities.
\2\ The description is not intended to be a comprehensive explanation of the underlying violation; the statute and corresponding regulation, if
  applicable, should be consulted.
\3\ Statutory or Inflation Act Adjustment.
\4\ The cost of living multiplier for 2019, based on the CPI-U for the month of October 2018, not seasonally adjusted, is 1.02522, as indicated in OMB
  Memorandum M-19-04, ``Implementation of Penalty Inflation Adjustments for 2018, Pursuant to the Federal Civil Penalties Adjustment Act Improvements
  Act of 2015'' (December 14, 2018).
* For each false record or statement, 10,000 per day.
** For each false record statement, 10,461 per day.



[[Page 59567]]

    Dated: October 28, 2019.
Alex M. Azar II,
Secretary, Department of Health and Human Services.
[FR Doc. 2019-23955 Filed 11-4-19; 8:45 am]
 BILLING CODE 4150-24-P