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Revisions to Civil Monetary Penalties May Be Coming

HHS has proposed two new rules to make changes to the Office of the Inspector General’s (OIG’s) Civil Monetary Penalties Law (CMPL) regulations. These rules will allow provisions required by the Affordable Care Act (ACA). The first rule notes that several sections of the ACA warrant CMPs, assessments and exclusions, including:

  • Failure to grant access/timely access to the OIG
  • Ordering/prescribing when excluded
  • Making false statements/omissions/misrepresentations when enrolling
  • Failure to return an overpayment
  • Making/using a false record/statement for a false or fraudulent claim

Additionally, HHS wants to clarify the CMP regulations to provide clarity and to give the public more access to the regulations.

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