US · guidance
CMS Pub. 100-04, ch. 30, § 140.12
Imposition of Sanctions
Section 1842(1)(3) of the Act provides that if a physician knowingly and willfully fails to
make a required refund, the Secretary may impose the sanctions provided in §§1842(j)(2)
of the Act. These include assessments of double the violative charges, civil money
penalties (up to $2000 per violation), and/or exclusion from the Medicare program for a
period of up to five years. However, sole community physicians and physicians who are
the sole source of an essential specialty are not excluded from the program. The OIG
makes determinations to levy a monetary penalty or program exclusion based upon a
failure to make a refund.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
b8f4243a26caa0d57c79a2cd48b495013a91004159dcae3262d0f7b90a10d52f
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