Chapter 5: Key Laws in Healthcare Compliance

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Civil Monetary Penalties Law

Fast Facts

Title of law: The Civil Monetary Penalties Law (CMPL), exclusion of certain individuals and entities from participation in Medicare and state health care programs

Categories:

  • Fraud and abuse

  • Medicare

  • Medicaid

U.S. Code: 42 U.S.C. § 1320a–7a

Year enacted: 1981

Major amendments: Not applicable.

Enforcement agencies: U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS)

Link to full text of law: https://www.govinfo.gov/content/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXI-partA-sec1320a-7a.pdf

Applies to: Any person or entity that presents fraudulent Medicare or Medicaid claims to federal or state agencies; authorizes the secretary of the U.S. Department of Health & Human Services to impose civil monetary penalties, assessment, and Medicare and Medicaid program exclusion.

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