---
kind: "section"
citation: "42 C.F.R. § 1003.410"
title: "42"
number: "1003.410"
heading: "Amount of penalties and assessments for Contracting Organization."
url: "https://uscodex.org/cfr/42/1003.410"
---

# §1003.410. Amount of penalties and assessments for Contracting Organization.

- (a) **Penalties.**
  - (1) The OIG may impose a penalty of up to $25,000 for each individual violation under [§ 1001.400](/cfr/42/1001.400.md), except as provided in this section.
  - (2) The OIG may impose a penalty of up to $100,000 for each individual violation under § [1003.400(a)(3)](/cfr/42/1003.400.md?p=a-3), [(a)(5)](/cfr/42/1003.400.md?p=a-5), or [(e)](/cfr/42/1003.400.md?p=a-e).
- (b) **Additional penalties.** In addition to the penalties described in [paragraph (a)](#a) of this section, the OIG may impose—
  - (1) An additional penalty equal to double the amount of excess premium charged by the contracting organization for each individual violation of [§ 1003.400(a)(2)](/cfr/42/1003.400.md?p=a-2). The excess premium amount will be deducted from the penalty and returned to the enrollee.
  - (2) An additional $15,000 penalty for each individual expelled or not enrolled in violation of § [1003.400(a)(3)](/cfr/42/1003.400.md?p=a-3) or [(e)](/cfr/42/1003.400.md?p=a-e).
- (c) **Assessments.** The OIG may impose an assessment against a contracting organization with a contract under section 1857 or 1860D-12 of the Act (Medicare Advantage or Part D) of not more than the amount claimed in violation of § [1003.400(a)(4)](/cfr/42/1003.400.md?p=a-4) or [(a)(5)](/cfr/42/1003.400.md?p=a-5) on the basis of the misrepresentation or falsified information involved.
- (d) The OIG may impose a penalty or, when applicable, an assessment, against a contracting organization with a contract under section 1857 or 1860D-12 of the Act (Medicare Advantage or Part D) if any of its employees, agents, or contracting providers or suppliers engages in any of the conduct described in [§ 1003.400(a) through (d)](/cfr/42/1003.400.md?p=a..d).

## Notes

### Amendments

[81 FR 88357, Dec. 7, 2016, as amended at 88 FR 42841, July 3, 2023]

### 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.

### Amendments

[81 FR 88357, Dec. 7, 2016, as amended at 88 FR 42841, July 3, 2023]