US · guidance
CMS Pub. 100-11, ch. 16, § 20
Enforcement
Enforcement activity begins when: (1) deficiencies are serious enough to escalate directly
to the enforcement activity stage and/or; (2) core compliance deficiencies remain
unresolved during the compliance activity stage after providing the PACE organization
with the appropriate notice and opportunity to correct the deficiencies.
Enforcement actions (also known as “intermediate sanctions”) include the following two
categories of actions: (1) enrollment and/or payment suspensions and; (2) civil money
penalties (CMPs). Enrollment and payment suspensions are imposed for serious
contractual deficiencies defined by statute and are designed to ensure the deficiencies
which formed the basis for the sanction are corrected and not likely to recur. CMPs are
also intended to be imposed for serious contractual deficiencies defined by statute and are
designed to be punitive in nature. Depending on the particular deficiency and statutory
basis for taking the action, CMS may impose both suspensions of enrollment and
payment and a CMP.
[42 CFR § 460.40]
History
(Rev. 2, Issued: 06-09-11; Effective: 06-03-11; Implementation: 06-03-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
236d6dd06c1338e25f0cedd730ffb4f28d3c251a69b1b7f78ce7b1c705b7d988
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