§1003.220. Determinations regarding the amount of penalties and assessments and the period of exclusion.
42 C.F.R. § 1003.220
In considering the factors listed in § 1003.140—
It should be considered a mitigating circumstance if all the items or services or violations included in the action brought under this part were of the same type and occurred within a short period of time, there were few such items or services or violations, and the total amount claimed or requested for such items or services was less than $5,000.
Aggravating circumstances include—
The violations were of several types or occurred over a lengthy period of time;
There were many such items or services or violations (or the nature and circumstances indicate a pattern of claims or requests for payment for such items or services or a pattern of violations);
The amount claimed or requested for such items or services, or the amount of the overpayment was $50,000 or more;
The violation resulted, or could have resulted, in patient harm, premature discharge, or a need for additional services or subsequent hospital admission; or
The amount or type of financial, ownership, or control interest or the degree of responsibility a person has in an entity was substantial with respect to an action brought under § 1003.200(b)(3).
Notes, amendments, and revision history
Source
Source: 81 FR 88357, Dec. 7, 2016, unless otherwise noted.
Authority
Authority: 42 U.S.C. 262a, 300jj-52, 1302, 1320a-7, 1320a-7a, 1320b-10, 1395u(j), 1395u(k), 1395cc(j), 1395w-141(i)(3), 1395dd(d)(1), 1395mm, 1395nn(g), 1395ss(d), 1396b(m), 11131(c), and 11137(b)(2).
Source
Source: 51 FR 34777, Sept. 30, 1986, unless otherwise noted.