Penalty for any person that knowingly and willfully bills for statutorily defined State-plan approved physicians' services on any other basis than an assignment-related basis for a Medicare/Medicaid dual eligible beneficiary. (Penalties are assessed in the same manner as 42 U.S.C. 1395u(j)(2)(B) , which is assessed according to 1320a-7a(a))

For Penalty for any person that knowingly and willfully bills for statutorily defined State-plan approved physicians' services on any other basis than an assignment-related basis for a Medicare/Medicaid dual eligible beneficiary. (Penalties are assessed in the same manner as 42 U.S.C. 1395u(j)(2)(B) , which is assessed according to 1320a-7a(a)), agency is HHS; statutory authority is 1395w-4(g)(3)(B); maximum penalty is 19,940, 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

1395w-4(g)(3)(B) | <https://www.ecfr.gov/current/title-42/section-402.1#p-402.1(c)(18)> 42 CFR 402.1(c)(18) , <https://www.ecfr.gov/current/title-42/section-402.105#p-402.105(d)(2)(xiv)> 402.105(d)(2)(xiv) | CMS | Penalty for any person that knowingly and willfully bills for statutorily defined State-plan approved physicians' services on any other basis than an assignment-related basis for a Medicare/Medicaid dual eligible beneficiary. (Penalties are assessed in the same manner as <https://www.govinfo.gov/link/uscode/42/1395u> 42 U.S.C. 1395u(j)(2)(B) , which is assessed according to 1320a-7a(a)) | 2024 | 19,435 | 19,940

— 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.