Penalty for a HMO or competitive medical plan if such plan substantially fails to provide medically necessary, required items or services
For Penalty for a HMO or competitive medical plan if such plan substantially fails to provide medically necessary, required items or services, agency is HHS; statutory authority is 1395mm(i)(6)(B)(i); maximum penalty is 68,445, recorded from its source on 2026-08-10.
- Agency
- HHS our reading
- Violation
- Penalty for a HMO or competitive medical plan if such plan substantially fails to provide medically necessary, required items or services verified
- Statutory authority
- 1395mm(i)(6)(B)(i) verified
- Maximum penalty
- 68,445 verified
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) | <https://www.ecfr.gov/current/title-42/section-1003.410> 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