CMS Pub. 100-11, ch. 16, § 50

There are certain violations for which CMS will impose a civil money penalty (CMP).

The penalty is amounts up to the following maximum amounts, depending on the type of

violation.

CMP violations include:

• For each violation regarding enrollment or disenrollment specified in 42 CFR

§ 460.40(c) or (d), $100,000 plus $15,000 for each individual not enrolled as a

result of the PACE organization’s discrimination in enrollment or

disenrollment or practice that would deny or discourage enrollment;

• For each violation regarding excessive premiums specified in 42 CFR §

460.40(e), $25,000 plus double the excess amount above the permitted

premium charged a participant by the PACE organization (the excess amount

charged is deducted from the penalty and returned to the participant);

• For each misrepresentation or falsification of information as specified in 42

CFR § 460.40(f)(1), $100,000;

• For any other violation specified in 42 CFR § 460.40, $25,000;

ο The provisions of Section 1128A of the Act (other than subsections (a)

and (b)) apply to a civil money penalty under this section in the same

manner as they apply to a civil money penalty or proceeding under Section

1128A(a).

[42 CFR § 460.46]