Penalty for a HMO or competitive medical plan if such plan substantially fails to provide medically necessary, required items or services · 1395mm(i)(6)(B)(i)

For Penalty for a HMO or competitive medical plan if such plan substantially fails to provide medically necessary, required items or services, statutory authority is 1395mm(i)(6)(B)(i); agency is HHS; maximum penalty is 68,445, recorded from its source on 2026-08-10.

Values marked our reading are our classification of what the source says — the source does not print them in those words. The quote below is the evidence for each one; judge it yourself.

What the source says

1395mm(i)(6)(B)(i) | 42 CFR 1003.410 | OIG | Penalty for a HMO or competitive medical plan if such plan substantially fails to provide medically necessary, required items or services | 2024 | 66,712 | 68,445

— ecfr.gov, retrieved 2026-08-10

Source

• ecfr.govhttps://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-102/section-102.3

Last verified against source: 2026-08-10. Due for re-check by 2027-02-26. This page as Markdown · OKF bundle · full dataset as JSON.