Range of Penalty Amounts

10005.4 - Range of Penalty Amounts (Rev. 221; Issued: 05-10-24; Effective: 05-10-24; Implemetation:05-10-24) CMS bases the range of civil money penalty amounts on three levels of seriousness—upper, middle, and lower. The range of CMPs is identified at §484.485(b)(3) – (6) for HHA and §488.1245(b)(3) – (6) for hospice programs, and the amounts are adjusted annually for inflation and are posted on the CMS website. The specified CMP ranges mark the starting point in CMS’s determination of the CMP amount. First, CMS looks to the specific circumstances of the survey findings to determine whether a per day or per instance CMP is warranted and whether the facts point to a CMP rate in an Upper, Middle, or Lower range. After the CMP type and range are determined, CMS considers the additional factors described above at 10012.2. When CMS is determining the rates for multiple CMPs, the rates must be evaluated collectively. By law, CMPs may not exceed a set maximum amount per day. The maximum is a total, comprising per day and per instance penalties. This maximum is set forth at §488.845(b)(2)(iii) and at §488.845(b)(6) for HHA and at §488.1245(b)(2)(iii) and at §488.1245(b)(6) for hospice programs. Current information on the range of CMPs and the maximum amount per day is posted on the CMS website on the Quality, Safety & Oversight Group webpage at https://www.cms.gov/Medicare/Provider-Enrollment-and- Certification/SurveyCertificationGenInfo/Civil-Monetary-Penalties-Annual-Adjustments.html.